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INCREASING YOUR
MENTAL EFFICIENCY

Heredity and Mental Defect

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Increasing Your
Mental Efficiency

By

Edward Huntington Williams, M.D.

Formerly Associate Professor of Pathology in the State

University of Iowa; Assistant Physician, New York

State Hospital Service. Author of "The Walled

City; A Story of the Criminal Insane," "The

Question of Alcohol," "The Wonders of

Science in Modern Life," etc., etc.

Illustrated

Hearst's International Library Co.
New York MCMXiv

Ab^'s^I

Copyright, 1914, by
Hearst's Ihtesnatiohai. Libbabt Co., Iho.

All rights reserved, including that qf translation
into foreign languages, including the Scandinavian

CONTENTS

CHAFTEB FAQB

I Caring foe the Child's Mind ... 11

II Mild Forms of Disturbed Equilibriitm 47

III Danger Signals 68

IV Nourishing the Mind 95

V Stabilizing the Faculties .... 112

VI The Problem of Ancestry and Envi-
ronment 156

VII Increasing Our National Efficiency 175

Vni A National Movement to Improve

Mental Efficiency 224

ILLUSTRATIONS

Heredity and Mental Defect . Frontispiece

FACINQ FAOE

The Old vs. the New-
Hogarth's " Bedlam"
Patients ' Tea Party in a State Hospital 66

Structural Changes in Mental Diseases . 114

Patients Playing Croquet at St. Lawrence

State Hospital 176

INTEODUCTION

rpHE care of the mind involves development,
■■■ education, and training. The terms are by
no means synonymous. A highly developed mind,
for example, is not always a well-balanced one.
If not, it offers proof that too many years and too
much energy have been devoted to mental develop-
ment at the expense of proper training in correct
introspective judgment.

That the number of badly balanced persons is
increasing is shown by hospital records. It is an
open secret that insanity is steadily making head-
way — increasing at a rate out of proportion to
the growth of our population. And this at a time
when Education is the watchword of every com-
munity, and when illiteracy is steadily decreasing
in all portions of the civilized world.

But actual insanity is simply the more tangible
form of disturbed mental balance; and for each
person who exemplifies this extreme degree of
aberration there are scores who suffer from purely
mental maladies far less patent to the casual
observer but nevertheless just as surely the result
of disturbed mental balance. The vast army of
" neurasthenics " — a horde that has been steadily

7

8 Introduction

increasing since the days of our grandfathers —
offers evidence that mental hygiene is not keeping
pace with hygiene of the body. And the existence
of that still larger army— those peculiarly endowed
persons who are able to cure their imaginary ills
by the simple process of believing that the ills
are imaginary — demonstrates that a vast number
of persons are suffering from maladjustment of
their mental balance-wheels.

For we must always bear in mind this fact:
The diseased conditions of the mind which per-
vert the judgment in one individual to make him
a lunatic, in another to produce hysteria or neu-
rasthenia, and in a third, the plastic medium of
the faith healer, are dangerously close of kin. In
most instances the ailment represents a differ-
ence in degree rather than a difference in kind.
And one condition lapses into the other so imper-
ceptibly that not even the wisest physician can
say where one ends and the other begins.

When, therefore, the psychiatrist warns us that
we are showing grave symptoms of a nation
afflicted with " nerves," he is simply telling us
metaphorically that our minds are not being well
cared for, and are showing the effects of misuse.

Professor Dubois recently expressed this in
more direct and unmistakable terms. ' ' There are
some individuals whose reason is disturbed and
whose actions are guided by strange sentiments, ' '
says Dubois. ' ' When the mental disorder is very

Introduction 9

pronounced we confine these patients as madmen
or lunatics. They are numerous, for, according
to statistics, it is necessary to consign nearly ten
persons out of a thousand to the asylum. In
slighter degree, the disease permits of the sub-
ject living still in society, though his actions may
be peculiar and often culpable; we speak then of
the semi-insane or unbalanced, and endeavor to
establish the degree of their responsibility.
Finally, when the mentality of the patient ap-
proaches the normal, and somatic functional symp-
toms seem predominant, the pathological condi-
tion is termed a neurosis. These ' nervous ' cases
constitute the great bulk of the clientele of the
neurologist, while the psychoses properly so-
called belong to the domain of the alienist. * * *
There are only differences of degree between these
conditions. In all of them we find abnormal states
of mind."

In other words, this ever increasing army offers
proof that we have over-exerted ourselves in the
direction of mental development at the expense
of mental poise. At the same time it suggests
that it is high time to consider the balancing, as
well as the developmental process. To do this we
must raise mental hygiene to the level of physical
hygiene, so that soundness of mind will be con-
comitant with soundness of body.

Caring for the Child's Mind

"T ^rHETHEE a person becomes nervous or
" ' not," says Professor Lewellys F. Barker,
" depends upon two great factors (a) the consti-
tution he inherits from his parents and through
them from his ancestors generally; (h) the influ-
ences to which his body, especially his nervous
system, is exposed during Ufe, and particularly
during childhood."

The italics are my own. For I believe that it
is almost impossible to overestimate the impor-
tance of the first few years of life, in determining
the physical and mental condition of the adult.
It is possible to wreck the physique of the man
by a few years of improper feeding and hygiene
in childhood. The distorted little figure of the
hunchback offers convincing evidence. Yet those
familiar with psychic abnormahties know that
the proportion of mental dwarfs and hunchbacks
is far greater than those showing physical defects
— individuals whose minds have been distorted by
bad mental pabulum administered in childhood.
The two conditions often go together. But as a

12 Increasing Your Mental Efficiency

rule, improper nourishment is the penalty of
poverty, while bad mental training is observed
more frequently in the upper walks of life.

But in any station in life it is possible to pro-
duce one or both conditions, by improper nourish-
ment and care during childhood. Improper care
of the child's physical condition is frequently the
first direct stepping-stone to a regime of bad
mental traiaing. Thus the mother -who allows the
caprice of the child to influence her in selecting
its diet, is courting two dangers — ^physical deteri-
oration and mental perversion. Once the child
learns that its capriciousness about diet may be
gratified through wilfulness, it has entered the
highway leading to improper nourishment. The
result is inevitably a puny, sickly child, stunted
intellectually, and often morally depraved.

The remedy for food-caprices is obvious: the
child should be taught to eat what we know it
should eat, regardless of its likes and dislikes,
which, after all, are not strongly developed in
childhood. " The child that learns to eat and
digest all wholesome foods," says Professor Bar-
ker, ' ' and who is not permitted to cultivate little
food antipathies, makes a good start and avoids
one of the worst pit-falls of life with which medi-
cal men are very familiar, namely a finical anxiety
concerning the effects of various foods, all too
likely to develop into a hypochondriacal state."

In the days of our grandparents it was cus-

Caring for the Child's Mind 13

tomary to allow the cMld a wide latitude in kinds
of food, even very young eliildren eating the same
foods as their elders. Later came the fad of
giving children measured portions, and greatly
restricting the variety in diet. But the accepted
modern method is a more rational intermediate
course between these two extremes. Give the child
a liberal variety of simple foods, such as meat,
vegetables, and fruits, avoiding such things as rich
pastries, and such beverages as tea, coffee, and
alcohol.

For it has been found by practical experiment,
and laboratory observations, that a variety of
foods tends to increase digestive powers ; and that
even indiscretions of diet, although temporarily
distressing, tend to make the child hardy. Pam-
pered children are likely to have weak digestive
tracts — largely because those tracts have never
been called upon to resist improper foods. The
little urchin who munches green apples, green
cucumbers, and almost anything else that gets
within reach, is flirting with colic and other dis-
tresses. But the colic is seldom of very serious
nature; and it is a matter of common observation
that these same children rarely have digestive
troubles later in life.

Of course no one would advise feeding green
apples or cucumbers to youngsters, although they
will surely eat them occasionally without help or
knowledge of their elders. But, nevertheless, there

14 Increasing Your Mental Efficiency

is a measure of compensation for such indiscre-
tions, m the fact that the occasional eating of
improper food is unlikely to have a deleterious
effect upon a stomach accustomed to a great va-
riety in diet — a digestive tract that is able " to
meet all comers," so to speak. The child that has
developed that kind of a fighting stomach will not
be found later in life measuring his portions in
deadly grams and cubic centimeters, or choosing
his rations for the " calories " they represent,
fletcherizing, or dabbling in " health-food " fatui-
ties, which are the highways to dypepsia and the
dispensary.

Giving the child a variety of simple foods, then,
is simply a practical system of hardening his in-
ternal organs, and preparing them for the battle
of life. A somewhat analogous system of l;iarden-
ing the nervous and muscular systems should be
pursued at the same time. Indeed one system
should supplement the other.

Building up Resistance

Most mothers dress their children too heavily,
particularly in infancy, before the little ones have
reached an age at which they can express their
feelings intelligently. But during the first few
months of life this is of little consequence if
practiced consistently. "When the child begins to
run about, however, a gradual course of judicious

Caring for the Child's Mind 15

hardening of the body is most desirable, to
strengthen the resistance to colds and other dis-
eases; and to insure an indifference to climatic
changes later in life. An active child requires
less clothing than an adult, and, unless it is of the
non-reacting, feeble type, should be clothed much
lighter. In this way the skin becomes hardened
to ordinary changes of temperature, sometimes to
an astonishing degree, and this condition will per-
sist through life, and be a great source of comfort
in our changeful climates.

A robust child should be given a cool bath every
morning, and should of course be encouraged to be
out of doors taking bodily exercise most of its
waking hours, regardless of weather. It is as-
tonishing how immune to colds and common child-
hood complaints such children become — sturdy
little citizens, well-equipped to battle successfully
with the great problems of life, the most important
of which is health.

Strengthening the constitution, if we may so
call it, increases the resistance to pain. And this
resistance produces an insensibility, or indiffer-
ence, particularly in children who play with other
youngsters of their own age, unhampered by the
solicitous supervision of a doting parent. For
children make light of the bumps and trifling hurts
of their companions, and learn to regard their
own injuries with indifference. Thus an obtuse-
ness to trifling injuries lays a secure foundation

i6 Increasing Your Mental Efficiency

for resisting, with proper fortitude, those greater
injuries, both physical and mental, that will surely
come later in life. In this manner a most bene-
ficial psychic and physical hardening process is
accomplished.

A child whose physical training has been along
the lines just outlined until its tenth year, let us
say, has taken a tremendous stride toward sound
physical adult life. If its mental training has
been correspondingly good, we may predict with
greatest certainty that, barring some extra-
neous calamity, such a child will round into
full manhood, or womanhood, with considerably
more than even chances for a long, vigorous
life.

It is obvious, therefore, that the principles of
mental hygiene should be applied at quite as early
an age as those of physical hygiene. They should,
indeed, begin in earliest infancy. For the task is
most important, and requires far greater intelli-
gence and persistence on the part of the instructor,
than mere physical training. The kind of mental
training that the child receives during the first six
or seven years of its life may taint or tarnish its
entire future. Obviously, then, the common type
of nursemaid is quite as incompetent to direct the
child's mind, as to supervise the later, or " finish-
ing-school " stage. Indeed, an ignorant nurse-
maid would do far less harm in a boarding-school
than in the nursery.

Caring for the Child's Mind 17

Harmful Early Impressions

It is impossible to overestimate the effect of
early impressions upon the mind of a sensitive
child. If you will think back over your own child-
hood for a moment, I venture to predict that you
will recall some early (and probably false) impres-
sion that you still remember vividly, to bear out
my assertion. It is not merely the baleful effect
of momentary mental tortures that children suffer
from such impressions as fear of the dark, fear
of goblins, and fantastic animals, that is impor-
tant, but suppressed fears that may cause actual
insanity later in life. The child that is instructed
properly is unlikely to become a prey to these
haunting fears, because it develops a rational, in-
stead of a superstitious trend of mind — an atti-
tude that tends to keep the ship of mentality on
an even keel, even m the roughest waters.

Children with bad heredity require more care-
ful instruction than those with a good heritage.
But unfortunately these delicately balanced chil-
dren usually live in a tainted atmosphere, even
when their actual instruction is excellent, since
one, or both of their parents are neurotic. Chil-
dren learn quite as much from observation of the
deportment in their associates, as by any course
of didactic instruction. Indeed, it still remains
an open question as to just how much inherited
instincts are responsible for the peculiarities in

i8 Increasing Your Mental Efficiency

the children of neurotic parents, or to what extent
environment influences the child. Both conditions
play an important part, and undoubtedly environ-
ment tends to develop the inherited tendency to
instability.

There can be no doubt, however, that even a
nervous child with a bad heredity may have its
mental balance firmly centered by proper environ-
ment. We see examples of this in orphan asylums.
On the other hand, the bad example of parents
may produce distressing nervous conditions even
in children of stable organization and good
heredity.

" In this domain of nervous diseases it is easy
to prove the contagion of example," says Dubois.
" We see little girls imitate their nervous father
or hysterical mother, throwing themselves upon
the sofa at the slightest fatigue and complaining
of backache and headache. They are sensible to
all exterior influences, cannot take food which they
do not like, and become unnerved like their
mother. They play so well the part of little nerv-
ous women that they are caught in the snare and
become so really. Nervous parents, think of this
danger of moral contagion."

What is to be done with a nervous child placed
in such surroundings ? The remedy that suggests
itself is removal to other surroundings. But this
is usually impracticable, and for several reasons
is not desirable if such a change implies denying

Caring for the Child's Mind 19

the child parental care. We could, indeed, correct
many of the tendencies to nervous outbreaks in
the child by making its surroundings similar to
those of the " institution children " reared in
children's homes. But while such surroundings
stabilize the nervous system, they also stifle the
higher psychic centers, because in such places the
subtle " mother's influence " is wanting. In a
phrase, the institution reared child tends to be
stable, stoical — and stupid. And stupidity is a
poor substitute for individuality, even though that
individuality be neurotic.

The only practical method at our command is
to impress upon parents the importance of teach-
ing by example, particularly in little, and appar-
ently inconsequential things. One of these ap-
parently unimportant things is the use of the
word " nervous " by many neurotic parents.
These persons use the term to express their own
wavering condition, or to excuse wilfulness in a
child; but in either case the use of the word is
pernicious, and cannot be condemned too severely.
It is a word that should be eliminated from con-
versation with, or in the presence of, children.
Parents who constantly speak of " being nerv-
ous " or of certain things " making them nerv-
ous "; or who excuse their own actions, or those
of the child, on the ground of " nervousness ";
are preparing fertile soil for nervous outbreaks in
the child later in life.

20 Increasing Your Mental EfEciency

Nothing can be more demoralizing to nervous
stability than constant reference to the opposite
condition. The impressible child seizes upon the
fact that there is such a condition as " nervous-
ness " — a thing that no normal and healthy chUd
should realize — and makes this an excuse for cer-
tain actions that are simply the result of wilful-
ness or selfishness. One exhibition of childish
temper that is excused or condoned on the ground
of " nervousness " leads to another, and still
another.

If the word must be used at all, it should be
given the same interpretation as " naughty," or
something reprehensible. Above all things do not
let the child of nervous temperament, if it must
be pampered or favored in certain ways, know
that it is so favored on account of its delicate
nervous organization. For these children are
quick to seize upon this excuse for exhibitions of
lack of self-control, or other erratic actions, which
lay the foundation for mental instability.

Another greatly abused term, one that should
be stricken from the lexicon of the nervous child
and its parents, is " temperament." Many per-
sons use this term to explain a peculiarity or
defect, or condone a fault. Others seem to
regard the expression, "he is temperamental,"
synonymous with "he is a genius." But
psychiatrists give a very different, and much
less flattering interpretation. To these the

Caring for the Child's Mind 21

"temperamental" person is a very unstable
one.

But whatever the intent — ^whether the word is
intended to convey the impression that a certain
person is unusually bright, unbalanced, has ex-
cessive nervous energy, or is simply a degenerate
— ^it is a bad word to use in the presence of chil-
dren. For it is used far too often as a cloak
to screen eccentricities. And whether these
eccentricities be the early manifestations of
genius, or, what is far more likely, abnormality,
it is bad mental hygiene to gloss over peculiarities
by the use of such an ambiguous term.

The fact that a child shows great precocity is
no valid reason for giving it a special training
that differs materially from that of less brilliant
children. There is little danger that such training
may stifle a budding genius. For genius will not
be suppressed by discipline intended to correct
eccentricities. On the contrary, an attempt to
hold the precocious child's mind to the normal
channels of childhood, will be far more beneficial
than encouraging it to run off on peculiar tan-
gents. Moreover, one can never be certain that
the child's apparent genius may not be simply
eccentricity, or abnormality. Most precocious
children fail to rise to a height even approaching
the realm of genius. And therefore it is doubly
important that these children be schooled in nor-
mal trends of thought. A race-horse that cannot

22 Increasing Your Mental Efficiency

run, but which has been trained for no other pur-
pose, is indeed a worthless creature.

The Dangers from Moral Contagion

Another reason why these highly organized, in-
telligent, and sensitive children, require more
careful training than the phlegmatic ones, is the
fact that such children are more susceptible to
" moral contagion " from the actions of their
parents. It behooves the parents of such chil-
dren, therefore, to encourage them to indulge in
the occupations and amusements of normal child-
hood, supplementing such training by good ex-
ample. The companionship of other robust chil-
dren has a healthful, stabilizing effect.

The practice of frightening young children, or
(arousing their apprehensions unnecessarily, is
most reprehensible. This is especially true as
regards the kind of fright that appeals to the
moral nature, such as superstitious fears of un-
natural things, referred to a moment ago. There
appears to be a great difference in ultimate effect
upon the nervous system, between ordinary physi-
cal frights, such as a narrow escape from falling
while at play, or a passing automobile, and the
kind of psychic terror produced by the fear of
goblins or ghosts. Frights caused by physical
danger are quickly forgotten; but superstitious
fear is persistent, and its evil effects can hardly

Caring for the Child's Mind 23

be overestimated. We are just beginning to ap-
preciate that some of the most incurable forms
of insanity, like many of the intractable nervous
diseases, such as stuttering, are the direct result
of childhood frights. " Every ugly thing told to
the child," says Mosso, " every shock, every
fright given him, will remain like a minute splin-
ter in the flesh to torture him all his life long."

The foolish mother, or ignorant servant girl,
who frightens a child into obedience by tales of
ogres, bogey-men, or anything mysterious, is pre-
paring fertile soil for the development of mental
instability. We may go farther, and say that the
teaching of any superstition whatever, is likely
to give the child an entirely perverted attitude of
mind. For the mind of a child is above all things
logical — much more so, indeed, at this period of
life before habits of thought have stifled logicality,
than the mind of the average adult. It does not
distinguish between one kind of superstition and
another, simply because no logical distinction
exists. And for this reason the thoughtless or
ignorant teaching of a single harmless supersti-
tion may pave the way to a belief in innumerable
harmful ones.

Possible Consequences of Little Deceptions

Let us consider, for example, the most common
form of deception practiced upon young children,

24 Increasing Your Mental Efficiency

that of the belief in Santa Glaus. To the majority
of people there appears no possible harm in de-
ceiving the child during its early years about
the jolly reindeer driver, and later correcting the
deception. And undoubtedly this in itself is one
of the most harmless of foolish deceptions, be-
cause it lacks the fear-producing element. The
tales about good fairies are likewise relatively
harmless in themselves, and for the same reason.
But even these seemingly harmless myths may lay
the foundation in the child's mind for a belief in
all manner of supernatural beings. If there is a
mysterious person who can fly through the air
and drop down chimneys, as Mother and Father
have taught, what is there inconsistent in some
ignorant servant girl's tales of goblins, or
ghosts? To the child's mind one is quite as
reasonable as the other. And so the foundation
is laid for a superstitious trend of mind that is
not consonant to practical twentieth-century en-
lightenment.

On the other hand, if the child has been told
that Santa Claus is a purely imaginary person,
it will be less ready to believe stories about
goblins or other imaginary monsters. To state
the case frankly, then, children should not
be deceived about Santa Claus, or any other
myth.

But, it is objected, by doing away with Santa
Claus you are robbing childhood of one of its

Caring for the Child's Mind 25

greatest pleasures — killiDg what little romance
is left in this all too prosaic life ! Not at all, my
dear reader. I have among my acquaintances
several children, now almost grown, who were
never taught to believe in the existence of Santa
Claus. They were told, as little children, that
Old Kris Kringle was purely a mythical person,
and that the hangings of stockings for him to fill
was simply a pretty custom. Never for one mo-
ment did any of those children believe that there
was really a Santa Claus. And yet I have never
seen children take greater delight in hanging up
their stockings on Christmas eve, or in planning
for the mysterious visits of this purely imaginary
character.

The good effect of this training was shown
in an incident that happened when one of these
children was six years old. This child had been
informed about the chimerical nature of all
" mysterious beings " as well as Santa Claus.
One day while playing with a little neighbor, she
heard a harrowing ghost story told by a super-
stitious maid. The child at once expressed her
doubts about the truth of the story, since her
father had told her that ' ' ghosts were like Santa
Claus, just imaginary things." Nor could the
maid shake her skepticism: her father's word
was, in her mind, the highest court.

A child with that attitude of mind is not likely,
later in life, to stumble on the rock of supersti-

26 Increasing Your Mental Efficiency

tion — a rock that fills our asylums and sani-
tariums.

, Early Religious Training

In this connection the question arises as to the
age at which the religious training of the child
should begin. I am fully aware that in this field
each parent is likely to be guided by his own
particular religious bias, and ready to challenge
the wisdom of all others. It is the one depart-
ment of education in which the standards and
methods of our parents and grandparents are
likely to be considered all-sufficient for our chil-
dren. But nevertheless, the practicalities of re-
ligious beliefs, like most other fields of thought,
have changed and progressed in the last century.
And our attitude toward the teaching of religious
subjects to children should have changed cor-
respondingly.

Fortunately, the tendency of religious teaching
to-day is to exalt the beautiful side of religion,
and suppress the terrifying doctrine of eternal
punishment. But for those who accept the literal
interpretation of this ancient belief (if, indeed,
there be any such persons) the warning given a
moment ago against the dangers attending psychic
frights in childhood should be repeated and em-
phasized. Terrifjdng the child at this receptive
age with stories of eternal punishment, is laying

Caring for the Child's Mind 27

a powder mine for a future explosion. If the
child is the nervous, sensitive type, this explosion
will come almost inevitably in one form or another
sooner or later.

Its worst form, of course, is some type of re-
ligious mania — an all too common form of mental
aberration which shows the effect of the exploded
powder mine. But besides this most terrible dis-
aster there are less pronounced afflictions that
" will remain like minute splinters in the flesh "
just as in the case of any other childhood fright.

" Keep out all fear of the brutal things men
have taught children about the future," says
Luther Burbank, the lover of plants and children,
in his book. The Training of the Human Plant.
" I believe emphatically in religion. God made
religion, and man made theology, just as God made
the country, and man made the town. I have the
largest sympathy for religion, and the largest con-
tempt I am capable of for a misleading theology.
Do not feed children on maudlin sentimentalism or
dogmatic religion; give them nature. Let their
souls drink in all that is pure and sweet.

" Rear them, if possible, amid pleasant sur-
roundings. If they come into the world with souls
groping in darkness, let them see and feel the
light. Do not terrify them in early life with the
fear of an after world. Never was a child made
more noble and good by the fear of a hell. Let
nature teach them the lesson of good and proper

28 Increasing Your Mental Efficiency

living, combined witli an abundance of well-bal-
anced nourishment. Those children will grow to
be the best men and women. Put the best in them
by contact with the best outside. They will ab-
sorb it as a plant absorbs the sunshine and dew."

The Persisting of Early Impressions

Any one who doubts the persistency throughout
life of childhood impressions will find food for
thought by observing the acquired habits that per-
sist even in those whose minds are completely
wrecked. It would be possible to cite specific in-
stances by hundreds.

A middle-aged man who was under my care for
some time had become so completely unbalanced,
a few years before, that it was necessary to confine
him in an asylum. He was, indeed, considered
dangerous, showed violent fits of temper, and had
to be watched constantly night and day. Event-
ually, however, he became less agitated, although
still greatly confused, and much demented. His
disease was incurable, but his condition had im-
proved sufficiently so that, with proper supervi-
sion, he could be given many liberties, and was
able to enjoy many of the pleasures of life.

When the hunting season arrived this patient
asked his medical adviser to be allowed to go
shooting. The request seemed preposterous, com-
ing from an irresponsible man who was subject

Caring for the Child's Mind 29

to violent fits of temper. But the physician had
had a wide experience with similar cases ; and he
had learned, moreover, that this patient as a boy
had been given unusually careful instruction about
handling a gun while hunting. Thus it had become
instinctive with him to carry his weapon with the
muzzle always pointing away from his companion,
and never in any circumstances to point a gun at
a person.

Feeling confident that his patient's early train-
ing would dominate his actions, the physician de-
cided to grant his request to go shooting. More-
over, the doctor decided to join him in the hunt,
although fully aware that the patient disliked him
thoroughly, and had threatened him repeatedly.

The physician's decision will strike most per-
sons as foolhardy. But subsequent events ,proved
the soundness of his judgment. For although the
patient was at times violently angry with the doc-
tor during their hunting trips, the thought of using
his gun as a weapon never suggested itself. Or,
if suggested, was at once rejected. The early
training in the use of weapons still dominated a
certain portion of this demented man's mental
mechanism, although most of that mechanism was
so badly askew.

Since habits of thought established iu childhood
undoubtedly lay the foundations for future mental
attitudes, it is obvious that certain habits should
be encouraged, while other tendencies should be

30 Increasing Your Mental Efficiency

diplomatically but persistently suppressed. In-
dustry, either in work or play, should be stimu-
lated to become a habit; for idleness in children,
as in adults, breeds all manner of mental and phys-
ical disorders. Once the habit of industry is ac-
quired it tends to persist through life.

Professor Ernst Haeckel, whose life has been an
almost continuous series of great achievements,
attributes his activity to his early training. ' ' My
mother," he says, " would never permit me to be
idle for a moment. If I stood at the window day-
dreaming, she would always urge me to be up and
doing. ' Work or play,' she would urge, ' but do
not stand idle.' Through this reiterated admoni-
tion, physical activity became a life-long habit
with me, and work almost a necessity of my being.
If I have been able to accomplish my full share of
labors, this is the reason. I am never idle, and I
scarcely know the meaning of ennui."

Idleness is the handmaiden of another fault, in-
decision. Indeed, the habit of idleness generates
indecision. The child that shows this tendency to
wavering should be taught tactfully to make de-
cisions, and abide by them. It is good mental dis-
cipline to acquire the habit of making some deci-
sion, even though it be a bad one.

Didactic Training Versus Muscular Development

It should not be understood that encouraging
activity in children implies urging the child to

Caring for the Child's Mind 31

make unusual efforts in its school work. The
bright, nervous child, frequently needs restraint
rather than urging in this particular field of ac-
tivity. Our modern school curriculums tend to
hurry the little ones on much too fast in the lower
grades for the welfare of their nervous systems ;
and err in the opposite extreme in the higher
grades, and colleges.

Instead of sending precocious children to school
early, and holding them to the task, it is far better
to devote more time to the development of their
muscles, and strengthening their nervous systems
(a " psychic hardening ") for a few years. For
if the child is below standard physically, as is fre-
quently the case, this driving process tends to
restrict, instead of develop, its natural capaci-
ties. And even in the exceptional cases, where
the mind develops at the expense of the muscu-
lar system, this brilliancy of intellect is scant
compensation for the halting, unstable physical
mechanism.

On the other hand, hard study is not injurious
to the normal, healthy boy or girl. It is good for
them. It teaches them to use their faculties, even
though the studies themselves may be of little
actual value later in life. Indeed, the real test of
value in a school or college course is its efficiency
in teaching students how to acquire knowledge,
rather than in the amount of knowledge actually
imparted. The college graduate is often singu-

32 Increasing Your Mental Efficiency

larly lacking in useful information. But if he has
learned the knack of acquiring knowledge during
his college course, his training may he considered
successful. Failure to acquire this, however, is
indeed utter failure.

Highly organized, sensitive children should not,
as a rule, be permitted to indulge in strenuous
mental contests, such as striving for prizes at
school. But if such contests are permitted, the
parent should note very carefully the effect upon
the child's mind and nervous system. Children
present two types of mental attitude in these con-
tests. In one, the pleasure of success predomi-
nates ; in the other, it is rather the fear of defeat.
In other words, one " loves to win," the other
*' hates to lose." And psychologically these atti-
tudes of mind may be very different. There are
types of persons who gloat over winning, but who
feel little or no humiliation in defeat; there are
others who feel relatively little elation at success,
but who are absolutely dejected by failure. If
your child is of this latter type — and no one can
determine this as well as the parent — do not let
him enter contests which require prolonged pre-
liminary effort. Contents brought about on the
spur of the moment have a far less deleterious
mental effect.

Caring for the Child's Mind 33

Beneficial Influence of the Playground

Nervous children are greatly benefited by play-
ground contests with other children of their own
age. If denied the companionship of other chil-
dren, or kept in the presence of older people, the
nervous systems of such children suffer from over-
protection. Such children are greatly benefited by
attendance at public schools. Even large private
schools, at least in America, do not serve the same
purpose. For the beneficial association with
" mixed classes " of children is wanting in such
schools, since the pupils are, almost without ex-
ception, the children of well-to-do parents. This
has its advantages, of course; but these are out-
weighed by the disadvantages. For every child,
when it reaches maturity, will be thrown in con-
tact with persons from all walks of life; and its
future success may depend largely upon its ability
to interpret the mental attitudes of persons in
every class. In other words, to understand human
nature.

No amount of experience in adult life will give
the peculiar intuitive capacity to estimate char-
acter that the child acquires by association with
heterogeneous playmates. Moreover, this min-
gling tends to stabilize the equilibrium of the
nervous child.

Persons of either sex, who have been denied
these playground associations, lack a well-rounded

34 Increasing Your Mental Efficiency

education, even though the didactic part of their
teaching may have been most complete. For the
playground, rather than the classroom, is the
builder of character. Here the child finds himself
placed in a niche consonant to his ability, physical
and mental. Paternal wealth, or position, counts
for nothing, only inherent worth as judged by the
peculiarly accurate standards of playfellows.
Thus the child learns, by contact with its play-
mates, to gauge its own abilities very accurately.
The conceited only child, obsessed with self-impor-
tance, soon learns his own shortcomings. It is a
helpful " leveling process " for the bumptious
youngster, and equally helpful to the intelligent
but timid child, by teaching confidence and self-
assurance.

Some mothers hesitate to send their children
to a public school for fear of the " coarsening
effect " of contact with such heterogeneoTis com-
panions. Children of such mothers are usually
mollycoddles — the very children who would be
benefited by contact and competition with all
classes of children. A proper home influence will
counteract any coarsening effect, while the play-
ground offers a kind of useful education that no
home supplies.

Many a doting mother has shed bitter tears at
the sight of her usually carefully pressed and
creased boy, returning from school, bruised and
bespattered after a set-to with some schoolmate.

Caring for the Child's Mind 35

But her tears miglit be spared : this same encoun-
ter may " be the making " of her boy. No single
event in a child's life is likely to have such positive
and permanent — and in the end, beneficial — effect
as a square-toed fight.

Most mothers will take radical exception to this
statement. But mothers are not competent
judges: they lack practical experience. Most
fathers, I feel sure, will concur in the assertion,
if they will recall the sensations produced by their
first youthful encounter. This sensation cannot be
produced by any other experience. In such con-
test, the boy for the first time, finds himself
thrown upon his own resources — a test of wit,
strength, and courage. And, win or lose, a new
sensation — one that the child will never quite for-
get — is born forthwith. It is a practical manifes-
tation of the primal fighting instinct — an instinct
which every successful man must possess. And
thus, just as the companionship of girls has a re-
fining influence on the boy's mental fibre, contests
with boys develop that other, and equally essential
quality.

And so I believe that any boy who is reared in
seclusion from boys of his own age, and grows
up without having at least one good square-toed
fight, has been deprived of a most important part
of his education. And being deprived of it, will
always retain a somewhat perverted outlook on
life, — a defective insight into human nature.

36 Increasing Your Mental Efficiency

Moreover, the boy who is a good fighter, is far
less likely to be quarrelsome than the coddled
nursery boy.

One must not confuse the petulant child, who
flies into a passion and strikes his smaller play-
mates or larger companions knowing that there
will be no retaliatory blow, with the sturdy play-
ground fighter. There is a wide gulf between the
types. Yet the playground itself is one of the
best remedies for petulancy.

On the other hand, pent-up emotions are danger-
ous elements in the developing child. The child
who sulks needs just as positive discipline as the
one that strikes. " Especial care should be exer-
cised to prevent disagreeable feelings and emo-
tions becoming transformed into the more persist-
ent moods," says Professor Barker. " It is often
better for an emotion to discharge itself in the
form of some definite act and thus bring it to an
end rather than through the partial suppression of
it, have it last in the form of a disagreeable mood,
for a considerable length of time. Pouting, sulki-
ness, harboring a grudge, or bearing malice, should
be regarded as symptoms seriously to be consid-
ered and corrected. For if they are tolerated in
the child, habits may be begun which will prepare
the soil for the development, later in life, of the
seeds of enmity and suspicion; the full-grown
plants are the persecutory ideas of the paranoiac
states.

Caring for the Child's Mind 37

The Remedy for Petulancy

" How to manage a child in a fit of temper has
been discussed. When possible it is desirable to
cut it short at the beginning. Some parents re-
joice to see their children reveal violent temper,
and are glad that they can fly into a passion, turn
red as a beet, clench the fists, and attack the in-
dividual with whom they are angry. Such attacks
if frequently repeated are very deleterious to the
nervous system. Some parents try to stop them
by petting and indulging the child, a kind of licens-
ing of irritability which rarely, if ever, pays;
others threaten the child or corporeally punish
him ; a mistake, usually, in the other direction. As
a rule most may be accomplished by purposefully
ignoring the attack, perhaps isolating the child
for a short period ; in some cases a warm bath and
the bed may be the best remedies.

" In older children the habit of giving way to
temper may sometimes be broken by inculcating
the conviction that one who loses his temper makes
a fool of himself, loses his dignity and excites the
disdain aud contempt of his fellows : the horror of
looking ridiculous, of making a donkey of one's
self, may be a most powerful lever in conquering a
tendency to attacks of fury. . . .

" Let no one think, however, that lack of feel-
ing, or a nature impoverished on the emotional
side is desirable or that it protects against nervous

38 Increasing Your Mental Efficiency

disease. The elevating emotions, hope, joy, ex-
pectation, . love — are constructive and are judi-
ciously to be cultivated ; the depressing emotions —
despair, sorrow, regret, and fear — are damaging
to the nervous system if long maintained. The
highest feelings of all, including the religious, the
ethical, and the aesthetic — inspire noble and useful
conduct, and in the education of nervous children
these sentiments are to be favored in their de-
velopment, in due degree, at a suitable age."

Defective eyesight, when it exists, is frequently
overlooked in young children. This defect ac-
counts for quite a high percentage of apparent
backwardness in school children, and may give rise
to temperamental peculiarities. Parents should,
therefore, have their children's eyesight tested at
an early age if there is any reason to suspect de-
fect. They can, indeed, make tests at home that
will determine with sufficient accuracy whether
the child is near-sighted — the most frequent con-
genital defect.

A very simple method of doing this is to select
pictures of objects with which the child is familiar,
such as the domestic animals from the "ABC
Book." By placing these one at a time at a dis-
tance at which their outlines are just discernible
with certainty by the parent's eyes (supposing, of
■sourse, that the parent's vision is normal) and ask-
ing the child to designate each, the vision of a
child can be readily determined. For the normal

Caring for the Child's Mind 39

length of vision, even of a young child, is the same
as that of the adult.

Special symptoms that should arouse suspicion,
particularly in school-children old enough to read,
are headaches, and nausea that is produced by
scrutinizing the printed page. Here the defect is
probably astigmatism — an irregularity in the
shape of the lens, or eyeball — which requires the
attention of an oculist, and should be corrected
by properly fitted glasses.

Every parent is confronted, sooner or later,
with the problem of choosing an occupation for
his child, or acting upon the child's own selection.
The general consideration of the question as to
just what part of the determination should rest
with the parent, rather than the child, is much too
complicated for discussion here. But there are
certain elements in the general proposition that
present themselves in the case of every child, and
should not be evaded. The two most vital ones
are, (1) the child's adaptation to the calling se-
lected — that is, its ability to perform its part suc-
cessfully; and, (2) the parents' ability to perform
their part, which is, in the last analysis, usually
the pecuniary item. To this should be added the
parental influence in guiding the child in making a
selection best adapted to its abilities and condition.

Even when the financial part need not be con-
sidered it is frequently most diflScult to make the
child's choice and its natural ability coincide.

40 Increasing Your Mental Efficiency

Moreover, it is quite impossible to determine dur-
ing the early years of childhood, for what calling
the child will be best adapted. For those who are
unhampered financially, this is, of course, the'
great item for serious consideration. And this
suggests the reason for the general rule that it is
better not to make any definite selection during
the child's early life. For the wisest person
in the world is unable to predict with certainty
what the inclinations and ability of a child of six
will be at sixteen, or twenty.

There are well-advertised men who make a
" specialty " of " fitting round pegs into round
holes." Were these charlatans actually able to
do even a tithe of what they claim, they would be
the greatest benefactors of mankind. For a very
large proportion of unhappiness and discontent
in this world is caused by misfitted " pegs." But
no single element can be determinative in this peg-
fitting problem. Circumstances, temperament, in-
clination, and natural adaptation must each be
taken into account, and the opinions of the child,
parents, and teachers must all be considered. And
finally, the child's capacity to carry out his part
of the compact, and the parents' ability to per-
form their part, must be largely determinant,
after all the other elements have been considered.

To attempt to determine in infancy what the
grown-up child shall follow as a vocation, is court-
ing disaster. Such early selection is, and should

Caring for the Child's Mind 41

be, the privilege of Royalty only. But most of us
doubt the wisdom of this practice, even in king-
making. For although there have been great kings
who were the sons of kings, we cannot forget the
numberless exceptions. None of the five greatest
rulers of Rome who reigned in succession were
hereditary monarchs.

" Find out what each child is capable of doing —
that is to say, his actual aptitudes ; and teach him
to succeed in these," says a modern philosopher.
And this is but an echo of the philosophical wis-
dom of all ages.

Sex Hygiene

One cannot consider the question of mental
hygiene for the child without specific reference to
the subject of sex hygiene which has recently be-
come a popular fad. Yet it should be evident to
every one that there is no real reason, or justifica-
tion, in this sudden activity about a subject that
is as ancient and as immutable, as civilization
itself.

Any subject is fraught with grave dangers when
it is promulgated as a fad. Likewise any vice
which is inherently attractive is likely to be dis-
seminated, rather than restricted, by propaganda.
Certainly the practice of giving great publicity to
the sex problem — treating the subject openly in
the presence of children — ^will do much more harm

42 Increasing Your Mental Efficiency

than good. For it is likely to direct the child's
mind into channels of investigation that should
not be explored until a later period in life.

The fact that such channels should, and do,
eventually become open highways, suggests the
only ground upon which the child may logically
be instructed. It is worse than futile to attempt
to frighten the child into believing that a thing
must be wholly bad, when this child will discover
very shortly (much quicker than most parents
realize) that grown up persons do not consider
the subject with any such degree of condemnation.
But it is possible to impress upon it the fact that
what may be a natural attitude of mind for adults,
is harmful for children.

If presented on any other ground the natural
logicality of the child will prick the bubble of de-
ception. But by impressing upon its mind the fact
that children should shun certain things, just as it
is better for them to avoid the use of tobacco,
alcohol, tea, or coffee, in their early years in order
to reach full development, the desired effect may
be accomplished. But do not, under any circum-
stances, attempt to instruct the child by frighten-
ing it ; for such a course is likely to have exactly
the opposite effect from the one intended. More-
over such a course may result in produc-
ing an abnormal suppression of a natural instinct,
with vitally disastrous consequences later in
life.

Cving for the Child's Mind 43

Pope may have had this particular vice in mind
when he wrote:

Vice is a monster of so frightful mien
As to be hated needs but to be seen;

Yet seen too oft, familiar with her face,
We first endure, then pity, then embrace.

In any event, the statement of the poet-philoso-
pher applies just as surely to the problem of sex
hygiene, and just as definitely to conditions to-day,
as it did to conditions existing a hundred years
ago.

The proper person, and the only person, to in-
struct the child in matters of sex hygiene, is the
parent. And in the case of very young children,
the mother can do this much more tactfully, as a
rule, than the father. The confidential relation
existing between mother and child is the logical
reason for this. For the subject is one that should
be treated only in strictest confidence. And if the
mother does not feel herself competent, she should
seek advice from the family physician, and trans-
mit her information to the child m her own way
and as the proper opportunity presents itself.

Teachers, ministers, or doctors, should not be
selected for this delicate task. For the instruc-
tions of such persons do not carry the same weight
as those of the mother, and are less likely to be
heeded. Moreover, the statements of an outsider

44 Increasing Your Mental Efficiency

— the fact that any other person may broach the^
topic — detract from the sacred secrecy of the sub-
ject which Mother may refer to without arousing
curiosity or apprehension, just as she may give
instructions about other necessary bodily func-
tions.

Determining the age at which the child should
receive this essential instruction is important.
Most parents deceive themselves in the belief that
their little ones remain utterly unsophisticated un-
til the age of puberty, at least. But this is not true
in a majority of instances, and should not be so.
For the period of puberty is the most important
of the child's life; and if the little girl is ignorant
of the natural and normal physical change that
takes place at this time, she may receive a psychic
shock, or be careless or indiscreet in the necessary
physical precautions, that may have disastrous
consequences.

We may make it a rule, therefore, that children
should be instructed before the age of puberty.
But this instruction should be of the most general
character, avoiding all but absolutely essential
details about natural biological functions, and
cleanliness. Moreover, the subject should be care-
fully avoided after the initial instruction. For
the child will remember every word that is told it
in this connection, and frequent reference to the
subject robs it of its confidential nature, and may
result in unnatural and morbid curiosity.

Caring for the Child's Mind 45

Every father should warn his son against the
pernicious " medical " advertisements published
so widely for the purpose of frightening young
men and bringing them into the merciless toils of
unscrupulous quacks. These advertisements play
upon the ignorance and credulity of the young men"
who may have committed some youthful and
harmless indiscretion, by describing chimerical
dangers, and professing to cure diseased condi-
tions that do not exist.

Few persons, except physicians, realize the
amount of positive harm and protracted unhappi-
ness produced by this pernicious literature. The
lives and usefulness of thousands of young men
have been permanently blighted by these adver-
tisements, to say nothing of the severe depletion
of their pocket books.

The deplorable thing about the whole obnoxious
subject is, that the claims and insinuations of these
criminal charlatans which so many boys read and
believe, are unmitigated lies. They play upon the
boy's credulity by leading him to believe that a
very common boyhood indiscretion — one that is so
common that it may be considered almost a normal
trait of youth — has blighted his life, or will do so
unless he patronizes the perpetrators of the ad-
vertisement. Whereas physicians know that little
harm comes from such indiscretion, which, in any
event, is self-corrective.

Fathers should explain the nature of these ad-

46 Increasing Your Mental Efficiency

vertisements to their boys. Or, if they feel that
their word will not carry sufficient weight in this
medical subject, they should arrange with the
family physician to do so. In this way the boy
will be given a correct understanding of many
seeming mysteries, and rendered immune to the
seductive literature of these discountenanced
medical sharks.

Failing in this, the boy may go through life
carrying a most oppressive burden — a closet skele-
ton that he would not reveal even to his most inti-
mate friend. And this sort of closet skeleton is
always a menace to mental stability.

n

Mild Forms of Disturbed Equilibrium

WE cannot hope to combat an evil without
some knowledge of its nature. So be-
fore suggesting methods of stabilizing mental
equilibrium, something should be said about the
various conditions that influence stability, and the
more tangible things that indicate a state of men-
tal unbalance.

Needless to say the indications will not be ex-
actly alike in any two cases, either in their course
or their termination, — that is, in any condition
which does not result in actual death. But in the
main they follow fairly well-defined highways, all
terminating in the condition included in the com-
prehensive term, insanity.

Unfortunately there are many derangements of
personality which, if uncorrected, may result in
this catastrophe. But if we can gain a clear con-
ception of some of these premonitory conditions
we shall have taken the most important step to-
ward correcting them. For it must be borne in
miad that although actual insanity is one of the
most incurable conditions, in the initial stages
when the mental balance is wavering on the bor-

47

48 Increasing Your Mental Efficiency

derline before taking the final plunge, it may be
prevented.

A recognition of this borderland state is our
■greatest safeguard ; since, contrary to popular be-
lief, insanity is seldom of sudden onset. Even in
cases where the mental balance appears to have
been unhinged by some sudden catastrophe, such
as some great shock, grief, or fright, we find al-
most invariably that there have been indications
of wavering equilibrium for some time — symp-
toms that an expert would recognize as danger
signals. Moreover, the nature of those signals is
usually such that even members of the victim's
household would have recognized them, were the
disease, insanity, as well understood as are many
of the physical ailments.

So that we can say with all but absolute cer-
tainty that, short of actual physical injury, no
mental or moral calamity will produce sudden in-
sanity in a healthy-minded individual.

The effect of the Titanic disaster upon the men-
tal condition of the survivors offers striking con-
firmation of this statement. There have been few
catastrophes in modern times in which the sur-
vivors suffered greater mental and physical
shock, and grief. To those unfamiliar with the
causes of mental aberrations it seemed that few
persons could pass through such an ordeal and
retain their normal mentality. Indeed, the rumor
that the incoming rescue ship, Carpathia, was " a

Mild Forms of Disturbed Equilibrium 49

floating mad-house " became so persistent, that
special arrangements were made to care for the
insane in the receiving wards of the City hospitals.

Yet when the Carpathia arrived at her dock, not
one of the Titanic survivors was insane. There
were many bowed with grief, several disabled
physically from exposure, or injury; but every one
was normal mentally. Moreover, a canvas of these
survivors a year later showed that no case of in-
sanity had developed.

On the other hand, several neurotic persons on
shore — persons having neither friends nor ac-
quaintances on the doomed ship — became insane
on hearing of the disaster. Yet in every one of
these cases the individuals were flying signals of
tottering mentality, and news of the great disaster
simply acted as the spark to set off the mine al-
ready laid.

We are powerless to prevent a certain number
of great calamities which result in terrible sacri-
fice of human life. But it is within our power to
avert many of the mental disasters that follow
in their wake.

Some Familiar Forms of Mental Instability

What particular form a mental aberration may
take in any individual case is of far less impor-
tance for our present purpose than a survey of
the premonitory shadows cast by the approaching

50 Increasing Your Mental Efficiency

cloud. Bearing in mind tliat every disturbance of
the emotions such, as unnatural elation or depres-
sion, fear, worry, suspicions, or doubt, when ex-
hibited to excess and without adequate cause is a
stepping stone to actual insanity, let us consider
somewhat in detail some of the peculiarities of
mental aberrations with which every person
should be somewhat familiar.

Without attempting to draw a fine distinction
between actual insanity and closely allied states,
we may examine some of the characteristics of
certain abnormal conditions which closely resem-
ble the more serious form, without necessarily
merging into it. The one with which every person
is more or less familiar, is hysteria.

Although the emotional manifestations of this
disease, such as excessive and unrestrained
laughter and weeping, are familiar to every one,
these are only the better known signs of a subtle
condition that may present a great diversity of
symptoms. Instability of temper, a tendency to
aimless dreaming, or an inclination to change from
one task to another, whether work or play, char-
acterizes the hysterical type of child. These chil-
dren are given to exaggeration, and love to do
startling and fantastic things, particularly in the
presence of susceptible and gullible parents. They
are often elated to a stage of ecstasy by trivial
events, and are depressed correspondingly by
trifling adversities.

Mild Forms of Disturbed Equilibrium 51

As a rule they are untruthful and unreliable,
are given to practicing deceptions, and lack the
frankness that is characteristic of normal child-
hood. They are likely to be bright and precocious,
frequently capricious about their food, and usually
(though by no means always) of poor physical
development.

These children have an abnormal craving for
sympathy, and resort to all manner of subter-
fuges to obtain it. If their self-absorption takes a
hypochondriacal form, they will simulate ill-
nesses in every gradation of severity from a
trifling cough to what appears to be actual paraly-
sis and even convulsions, — conditions that keep
the members of the sympathetic household danc-
ing attendance. And invariably they receive this
' ' danced attendance ' ' ; for even neuropathic chil-
dren seldom develop severe hysteria except when
surrounded by over-sympathetic, or foolishly in-
dulgent, parents.

The hysterical type of woman differs very little
in general characteristics from the hysterical child
except in those differences common to the two
periods of life. Indeed, most hysterical women
have been hysterical children. These women are
essentially childish in their attitudes of mind, and
tend to reproduce the peculiarities shown in child-
hood, somewhat altered to fit the changed condi-
tions. They demand the same attention of the
members of their households, exhibit a want of

52 Increasing Your Mental Efficiency

self-control, the tendency to impulsive actions,
irritability of temper, and the craving for novelty
and excitement. The basis of this condition is
undoubtedly defective will-power; although this
defect may be masked by a persistent stubborn-
ness that gives the impression of extreme wilful-
ness, particularly to the members of their own
households.

Their craving for sympathy is insatiable, and
represents a type of selfishness, which, with the
defective will-power, is a fundamental element of
the condition. There is scarcely any limit to the
length they will go to gain this sympathy. They
have been known to mutilate themselves to the
extent of producing serious injuries, starve them-
selves to the point of death, and simulate strange
and puzzling symptoms that are easily mistaken
for obscure pathological conditions. Every new
disease that is described in the popular press is
sure to be adopted by some of these patients. And
it is remarkable how faithfully they will imitate
in the minutest details symptoms that are un-
known to most laymen. Little wonder, therefore,
that they deceive sympathetic friends, and all too
frequently the family doctor.

Perhaps the most common form of deception is
a simulated paralysis in which the patient refuses
to walk, becomes bedridden, and lies in bed for
months, or years. Medical men have perfectly
definite methods of detecting this deception; but

Mild Forms of Disturbed Equilibrium 53

it is singularly difficult to convince the members
of neuropathic households of the real state of
affairs, even when the evidence is absolutely con-
clusive to others.

Some Radical Methods of Treatment

Sometimes a fortunate calamity is the means of
revealing the deception, where mere medical
science has failed. It has happened more than
once that actual peril, such as the burning of a
house, has stimulated the bedridden hysteric to
use her perfectly good limbs to save her life in a
manner that left no room for doubt about her
actual condition. The ' ' paralytic ' ' who can move
under the stimulus of danger is not suffering from
true paralysis.

The subterfuges resorted to by the old-time
physicians to ' ' bring these peculiarly afflicted
patients to their senses " are numberless. For
our medical ancestors did not regard hysteria as
a disease, but a mental state characterized by a
" devilishly persistent obstinacy." Yet some of
the methods of curing it were often most effective,
even if much too hard and crude to appeal to our
refined twentieth-century sensibilities.

The basis of these " cures " was the fact that
sudden danger sometimes caused the hysterical
paralytic to walk, demonstrating that the nervous
and muscular mechanisms were intact, but in need

54 Increasing Your Mental Efficiency

of proper stimulation. This naturally suggests a
remedy, which has been utilized in one form or
another many times, if we may believe popular
traditions that have been handed down through
generations of medical men.

One of the classic stories, which may well have
a basis in fact, is that of a certain young woman
who had been paralyzed and bedridden for many
months despite the efforts of the half dozen
physicians who were the medical scions of the
small town in which she lived. Each of these
physicians had been called successively to minister
to the sufferer; each had reached the conclusion
that the case was one of hysteria; and each had
been indignantly dismissed as soon as he an-
nounced his decision to the family — ^illustrating
the characteristic attitude of neuropathic families.
When the sixth, and last, physician had been dis-
charged the distracted father was at a loss to know
where next to turn for assistance, since the list
of available medical talent had been exhausted.

It happened that there was living in the town a
retired physician, a decrepit old man who was still
the medical oracle of the vicinity, although no
longer able to minister to the sufferings of his
worshipful townsmen on account of infirmity. As
a court of last appeal the distraught father sought
this venerable physician, and begged him for old
time's sake to try his skill upon the bedridden
victim.

Mild Forms of Disturbed Equilibrium 55

The old physician, who was still in touch with
the medical gossip of his confreres if not in active
competition with them, was cognizant of the true
nature of the form of " paralysis " with which
the girl was afflicted. And deeply sympathetic
with the distressed father, and probably somewhat
impatient with the girl for her wilful selfishness,
he finally agreed to take charge of her case. But
only on this condition : He was to treat her in his
own way, without interference from any relative,
friend, or outsider.

The father thankfully agreed to this condition,
and arranged for the treatments to begin the fol-
lowing morning. At the appointed hour, there-
fore, the old doctor appeared in the dooryard,
driven there in a light wagon, in the back of which
was a well-stuffed straw tick. This mysterious
therapeutic implement was deposited in the front
dooryard by his muscular assistant who had acted
as driver, while the physician visited the patient.

Without wasting any time over unnecessary
preliminaries, and disregarding the solicitous in^
quiries of the mystified father, the old doctor or-
dered the girl to get up. And when she protested
her inability to do so, commanded her mother to
dress her. ' ' For I intend to have her take a little
walk all by herself before I leave," the old man
announced. After which he held a whispered con-
versation with the muscular driver, and returned
.with him to the sick-room when the dressing was

56 Increasing Your Mental Efficiency

completed. At a nod from the doctor this assist-
ant picked the girl up bodily, carried her into the
yard, and deposited her on the straw tick. Then
he took his station beside the agitated, and now
thoroughly apprehensive father, while the doctor
began his treatment.

The preliminary part of this treatment was a
speech by the aged physician in which he explained
matters very thoroughly to the astonished and
highly indignant patient. He pointed out to her
that her condition was purely imaginary, and that
she could walk if she chose to do so ; but since she
was selfish, she preferred to stay in bed and keep
her poor old father and mother waiting upon her,
regardless of the fact that she was wrecking their
lives and their fortunes.

" You have been fooling these poor old people
long enough," the physician said, shaking his
trembling finger at the bewildered patient ; ' ' but
you can't fool everybody. I know you can walk
if you care to, and I'm going to prove it right
now."

With that the old man drew a match from his
pocket, and lighted one corner of the straw tick.

" Now walk or burn," he commanded.

By this time the distressed father was thor-
oughly convinced that the old man had gone stark
mad; and when the physician set fire to the mat-
tress he was certain that he had consigned his
daughter to the care of a maniac. Disregarding

Mild Forms of Disturbed Equilibrium 57

his promises of yesterday, therefore, he sprang
forward to rescue his suffering child from the
flames and the impending disaster he had brought
upon her. But he got no farther than the waiting
embrace of the muscular driver, who pinned his
arms and held his struggling prisoner at a safe
distance from the blazing mattress. Meanwhile
the good old mother, herself too feeble to effect
the rescue, collapsed in a distracted heap on the
door-step.

Thrown absolutely upon her own resources, with
no alternative but to burn or run, the girl made
the inevitable hysterical choice, sprang from the
blazing couch and ran into the house — demon-
strating conclusively that the old doctor had diag-
nosed her condition correctly.

The Secret of Miraculous Cures

Now in all probability this particular incident
never occurred exactly as related here. Yet it is
perfectly certain that if any one of these bedrid-
den hysterics were placed on a blazing mattress, as
this one is alleged to have been, she would sud-
denly regain the use of her limbs. But the defect
of this method of treatment lies in the fact that
" cures " attempted by it are usually only tem-
porary. It would not necessarily change the vic-
tim's attitude of mind; and unless this were ac-
complished, she would presently develop some

58 Increasing Your Mental Efficiency

other form of subtle malingering to deceive and
distress her afflicted family. For this reason the
modern physician does not resort to the crude ex-
pedients of his predecessors, but directs his efforts
to getting at the basis of the malady, instead of
striking at its peculiar manifestations.

Moreover, we know now that hysteria is an
actual disease with definite pathological manifes-
tations that may be easily demonstrated, such as
areas of insensibility of the skin, and mucous sur-
faces, the existence of which is not suspected by
the patient. Yet the condition is so closely de-
pendent upon the patient's attitude of mind, that
it is only by changing and correcting this attitude
that permanent cures are effected. In proof of
this, witness the number of " miraculous cures "
effected by faith alone — the piles of crutches that
psychic cripples have left at a hundred shrines
when their will-powers have been strengthened by
faith. The evidence is indisputable; but many
people fail to interpret correctly the meaning of
the seeming miracle.

We see these same miracles performed in a
much less spectacular, although quite as effective
a way, in sanitariums every day. And the secret
of these cures is a perfectly open one — that of
changing the patient's introspective trend of
thought into better channels leading to a different
and more rational attitude toward herself, thus
strengthening the will-power. Such cures are

Mild Forms of Disturbed Equilibrium 59

much more likely to be permanent than the tem-
porary improvement produced by sudden frights,
or kindred methods, because they reach the foun-
dation of the diflSculty, instead of merely touching
a surface manifestation.

It should be said in extenuation of the selfish-
ness that lies at the bottom of hysteria, that the
condition is due partly to an inherited defect for
which the patients cannot be justly blamed.
Neither should they be censured, if their early
training and environment have been such as to in-
crease, rather than suppress, their hysterical tend-
encies. But no such exoneration can be given
the parents who were responsible for this environ-
ment.

If these victims had been given proper train-
ing in childhood, and helpful surroundings, most
of them would escape hysterical manifestations
later. In short, the onus of responsibility for
hysteria frequently rests with the relatives of the
patient, rather than the patient herself. Nervous,
hysterical parents produce hysterical offspring;
the stable type do not. And this fact should be
borne in mind by the members of every neurotic
household in dealing with children, or adults,
whose mental attitudes are directly influenced by
environment.

Hysteria may have its origin in some forgotten
shock or disagreeable experience' of early child-
hood — a suppressed emotion of the subconscious

"6o Increasing Your Mental Efficiency

mental life, whicli still remains a source of dis-
turbance. The course of development of every
cMld is punctuated by these suppressed emotions ;
but in stable individuals these emotions remain
dormant throughout life. In neuropathic children,
however, they tend to assert themselves later. Yet
even in such children they may be kept in a quies-
cent state by parents who exercise that highest
form of mental hygiene usually characterized as
" common sense." A similar course in mental
hygiene will be just as effective in suppressing
the tendency in the nervous individual later in
life.

The point of interest in hysteria here is that it
sometimes precedes and merges into a condition
of actual insanity. And falling short of this, it
may permanently blight an otherwise useful life,
which a little intelligent direction might have
saved.

The Physical Effects of Worry

Another condition which has become very com-
mon in recent years, is that symptom of mental
and nervous exhaustion which we call neuras-
thenia. Many persons suppose that this condi-
tion is merely a form of hysteria. But such is not
the case.

The great difference in the two conditions is
that hysteria may be the result of a forgotten

Mild Forms of Disturbed Equilibrium 6i

shock, plus a neuropathic make-up ; while neuras-
thenia is usually the result of conscious worry
accompanying, or producing, brain fatigue. This
brain-fatigue may be the result of an actual ill-
ness, although it is more likely to follow overwork
with the accompanying factor, worry. It should
be added, also, that most sufferers from neuras-
thenia have a highly developed, sensitive, and
somewhat unstable nervous organization.

I have emphasized the element, worry, as a fac-
tor in producing neurasthenia, because I believe
that it is this, rather than overwork, that is largely
responsible. Indeed, if we eliminate those cases
of neurasthenia which come as the direct result of
some organic illness, we find that mental agitation
is responsible for practically all cases.

"When we consider the mechanisms by which
physical and mental work is performed we find
the explanation of why either of these factors
separately, or both of them together, without the
added element, worry, are unlikely to produce
more than temporary neurasthenic conditions.
The amount of work that our muscular systems
can perform is limited by the muscles themselves.
When a certain stage of exhaustion is reached the
muscle refuses to contract, no matter how much
we may " will " it to do so. We can, by sheer
force of will-power, drive it up to a certain point —
much farther than is desirable, frequently — ^but
there is a fixed limit beyond which it cannot be

62 Increasing Your Mental Efficiency

driven. And when this point is reached the mus-
cle stops acting, to rest and recuperate.

The point of limitation is just as clearly defined
in the mental mechanism as in the muscle, al-
though less patently so. The muscle rests itself
by actually stopping the contraction of its fibres ;
while the mind, which is normally active in one
of a thousand ways during every moment of con-
sciousness, finds means of resting any overworked
portion of its structure by throwing into activity
some other less fatigued portion. And this
process of mental resting by shifting the " cen-
ter " of activity is beyond the control of the will.

Most persons have had illustrations jof this
when performing some task which required pro-
tracted and concentrated mental effort. After a
certain number of hours of work, varying of
course in different individuals, the mind tends to
wander from the task in hand, and it requires con-
stant effort of the will to keep the attention
focussed. For a time it is possible to do so, if one
is accustomed to concentrated mental effort. But
presently a stage of exhaustion is reached in
which the mind absolutely refuses to " stick to
the subject " — goes skylarking off into some other
channel of thought. It has, in short, called off the
work in hand for the time being, and is resting
itself by wandering into fields where the con-
stellations of brain cells are less exhausted.
I Thus the brain has its own insistent method of

Mild Forms of Disturbed Equilibrium 63

recuperation even in our waking hours, and will
take its modicum of rest whether we will or no.
This mental safety-valve makes it practically im-
possible to injure the brain with work. And ex-
perience shows that hard work alone, or even a
combination of mental and physical exertion of
the most strenuous kind, seldom cause a mental
breakdown.

But when we add the additional factor, worry,
we form a combination that spells disaster. For
the brain is incapable of automatically switching
off this tormentor, as it does legitimate work. In-
deed the brain that is exhausted by work seems to
offer a particularly fertile field for the invader.
Eestful sleep does not come. Disturbing, half
waking dreams, keep the brain active during the
night, and daylight finds an exhausted nervous
system that should be fully recuperated.

This condition of exhaustion may be demon-
strated in the changed structure of the brain cells
themselves. It is found that such things as shock,
grief, fright, worry, and work, both muscular and
mental, produce a degenerative change in the
brain cells that may be demonstrated microscop-
ically — an actual wearing out of the tissues. Eest,
even for a very short period, replenishes this
waste, as shown in the restored brain cells. But
if these cells are kept in a constant state of ex-
haustion by worry, they are given no chance for
recuperation, and a mental breakdown may result.

64 Increasing Your Mental Efficiency

The Penalty of Mental Agitation

We hear constantly of " nervous prostrations "
from overwork. Students break down from over-
study; business men collapse under the strain of
excessive work; and women succumb to social
activities. But in every case, practically without
exception, it is the insidious element, worry, that
causes the collapse. And so there is full justifica-
tion for the old adage that, " Work kills no man,
Worry many."

In no field of mental derangement is this better
illustrated than in neurasthenia. And in this term
we include every gradation between mere mental
waverings and complete prostrations. The dis-
ease is, indeed, the penalty and product of our
modern strenuous methods of life, in which men-
tal agitation is a conspicuous element.

Nearly every person who is subjected to pro-
longed mental application with attendant worries
suffers from neurasthenic symptoms temporarily.
But this state of transient mental fatigue cannot
be considered as true neurasthenia. Even in
highly organized, emotional individuals, this con-
dition is usually self-corrective, unless accom-
panied by some exhausting physical disease.

True neurasthenia is likely to begin with pro-
longed periods of insomnia, which may alternate
with periods of unrefreshing sleep. The sufferer
feels dull, and lacks energy on arising, his general

Mild Forms of Disturbed Equilibrium 65

condition improving as the day advances — a con-
dition almost pathognomonic of debility. He
notices, also, that his memory is dulled for recent
events, and he finds difficulty in concentrating his
thoughts. Frequently after reading a page he
finds that he has not understood a line, his
thoughts having gone wool-gathering while his
eyes scanned the words. He reads the page again
— re-reads it several times, perhaps — but is unable
to fix his attention upon the subject after the first
few lines.

Obviously his mentality is below par ; and this
condition becomes at once a source of worriment,
and apprehensive introspection. He begins to
dread the tasks which were formerly routine day-
duties for him, and to doubt his ability to perform
them. Little things irritate and annoy him un-
duly, and his usual cheerfulness may be replaced
by moody melancholy. In some cases marked
irresolution, hesitation, and lack of will-power are
characteristic. The victim is harassed by indeci-
sion over trifling matters. He cannot decide what
suit or tie he shall wear, which train he will catch
to town, and doubts his ability to take the train at
all once he has reached the station.

He may be obsessed with the idea that he will
make mistakes in his work, and makes mountains
out of a hundred and one little mole-hills that are
sure to be encountered in his everyday employ-
ments. Thus he is worried about his mental con-

66 Increasing Your Mental Efficiency

dition ; and in the wake of these obsessions comes
the inevitable worry over bodily ailments.

One of the early symptoms of this disorder is a
loss of appetite, and also a disinclination to take
sufficient quantities of liquids. The neurasthenic
seldom seeks relief from his troubles in drink.
And thus he is deprived of the three elements
necessary to repair his organism and restore his
lost energy, — foods, liquids, and sleep. The result
is a deranged digestive tract added to a weakened
nervous system. The sufferer is indeed ill, phys-
ically as well as mentally.

The chain of morbid symptoms exhibited by
these hypochondriacal persons, while differing in
each individual, of course, follows fairly well-de-
fined trends of thought in most cases. Some of
them have a dread of open places (agoraphobia),
such as an open square or city street ; others fear
enclosed places (claustrophobia), such as a car, or
room, with the doors closed. In some the dread
of a particular disease such as cancer, appendi-
citis, or tuberculosis predominates ; or they cannot
bear noises such as the rustling of paper, or have
a morbid fear of cats, dogs, or horses. Indeed, if
we were simply to catalogue the names of the mor-
bid " phobias," the list would fill many pages. It
would require a vivid imagination to conceive any
form of " phobia " that has not been exhibited by
this type of sufferer at one time or another.

As we shall see in another place, many of these

Hogarth's " Bedlam "

Patients' Tea Party in- a State Hospital
THE OLD YH. THE NEW

Mild Forms of Disturbed Equilibrium 67

peculiarities are characteristic of certain forms of
actual insanity. And no one will question the
abnormal mental condition of a man who has
changed from a vigorous, active, clear thinker, to
one who spends hours in deciding what suit he
shall wear, turns pale if the family cat enters his
room, fears to cross a street he has crossed a
thousand times, cannot trust himself to sign his
name, and firmly believes that he is stricken with
tuberculosis although assured to the contrary by
trusted medical advisers. He is abnormal, mani-
festly ; and he is dangerously near the borderline.
But in several ways he differs from the man ac-
tually insane. He is still amenable to reason, at
least temporarily, still hopes to recover, and wishes
sympathy. Whereas the person actually insane is
not open to reason, is past caring for sympathy,
and neither desires nor hopes for recovery.

The importance of this condition from our pres-
ent point of view is (1) that it may merge into
actual insanity; (2) even in its worst forms it is
curable; and (3) it is a condition which may be
prevented by proper mental discipline. In any
event, it should not be regarded as a purely imagi-
nary illness, even though it is frequently a condi-
tion so closely dependent upon the mental state
that it may be cured by rigid mental, and physical
hygiene, without the aid of medication. The
method of applying this mental discipline will be
suggested in a later diapter.

m

Danger Signals

UNDOUBTEDLY the least understood of all
diseases among the generality of people is
insanity, or what the modern alienist refers to as
the psychoses. Every intelligent person has a fair
degree of more or less accurate knowledge about
the symptoms of quite an imposing array of other
diseases. It is a part of common knowledge to
know the symptoms of threatening throat, lung,
and intestinal troubles, and among better in-
formed persons there is a fair understanding of
the more obscure maladies, such as those involv-
ing the internal organs, and even the nervous
system.

But there are few persons indeed who have any
true conception of insanity itself, or what the
symptoms leading up to this calamity may be like.
And yet the importance of such knowledge can
hardly be overestimated. There are few diseases
that give such prolonged premonitory warnings
of its approach, or in which the early recognition
of these symptoms is of such vital importance.
For despite the fact that the causes, symptoms,

68

Danger Signals 6g

and course of mental diseases are well understood
by the modern physician, the methods of treating
these diseases, once they have become established,
are scarcely more effective now than in the days of
our grandfathers.

Our chief defence against insanity, then, like
contagious diseases, is prevention. But this de-
fence, to be successful, cannot be left to medical
oflScers, or quarantine laws alone, but requires the
cooperation of all intelligent laymen. For we can-
not exclude this pestilence by shutting the gates
of a city, or closing a few ports of entry, since
there are " foci of infections " in every city, vil-
lage, and countryside. To suppress these foci we
must learn to recognize certain premonitory symp-
toms that indicate their existence, just as we have
learned to recognize the important symptoms of
incipient bodily ailments.

For this purpose it is not necessary that the in-
telligent observer should possess an accurate
knowledge of the varied forms of insanity, but
rather the general character of the more pro-
nounced symptoms. He must, first of all, remem-
ber that insanity is a disease, or group of diseases,
that affect personality — a certain definite change
in conduct, which, in the beginning, may depart
very little from the normal conduct of the in-
dividual.

70 Increasing Your Mental Efficiency

Adjustment to Social Environment

" Speaking in a broad, general way," says Dr.
M. S. Gregory, " mental health may be defined as
the ability of the individual to adjust himself to
his social environment. By this, I mean his ability
to adapt himself to society, its customs and con-
ventions — the social fabric in which he lives and
of which he is a part. Mental life thus consists
of a continuous process of adjustment, and the
measure of mental health of an individual is
directly proportionate to his ability to adapt him-
self to his social environment.

' ' However, we are not bom equal. Many come
into the world burdened with traits, tendencies, and
defects which seriously impair their power of ad-
justment; while others, in addition to a vicious
heritage, have the still greater misfortune of being
exposed to faulty and unfavorable environmental
factors which accentuate their inherent defects
and tendencies, thus completely depriving them of
the ability to adjust themselves.

" Some suffer maladjustment by reason of
faulty habits — mental and physical ; by misunder-
standings of themselves and their relations to
others. Many of us have desires, longings, and
ambitions which must be repressed and sup-
pressed, as they cannot be gratified, but neverthe-
less make our adaptation to our social environ-
ment extremely difficult. Intellectual or social

Danger Signals 71

adjustment is obviously more difficult than phys-
ical, because the elemental factors of mental life
are more complex and variable.

" As in the case of physical life, one meets with
all gradations of maladjustment from total dis-
ability to slight deviation. Thus among those
wholly unable to adjust themselves are found the
imbeciles, idiots, and profoundly demented. These
require segregation and an institutional life. In
lesser degree, we find the weak-minded, and some
types of chronic insane who show some slight
power of adjustment. Another class includes
those who have a higher but still incomplete de-
gree of adjustment — such as in epilepsy or the re-
current mental disturbances. Another large
group comprises those who are capable of com-
plete adjustment with assistance, such as neuroses,
neurasthenics, psychopathies, alcoholics, and so-
called nervous people. Finally, we might mention
persons who are odd, eccentric, have the so-called
artistic temperament, who show only a very slight
degree of maladjustment."

In a general way we may group the symptoms
of approaching, or threatened, mental derange-
ment in two grand divisions — those in which there
is abnormal depression, or those exhibiting the
opposite condition of abnormal excitement, or ex-
altation.

72 Increasing Your Mental Efficiency

The Significance of Mental Depression

Unreasonable or unusual depression, particu-
larly in a person of nervous temperament, should
be regarded with suspicion, always remembering
that fleeting feelings of depression are experienced
by every normal person. But when the feeling of
depression persists, and is accompanied by loss of
appetite, failing nutrition, and sleeplessness, it
should be regarded with apprehension, particu-
larly in persons of usually buoyant spirits. Great
grief, or distress, will, of course, produce depres-
sion in every normal individual ; but in the case of
persons with stable equilibrium this is naturally
and normally mitigated, and the usual state of
buoyancy restored by new interests and aspira-
tions. In this manner the mind adjusts itself to
its new surifoundings. There has been a definite
cause for the depression, and a normal, healthy
reaction from it.

But the beginning of the form of depression
which may develop into actual melancholia is fre-
quently more insidious. Trifling annoyances
about household duties or business matters pro-
duce needless worries; the sufferer seeks seclu-
sion, loses interest in work or is disinclined to
work at all, and does not indulge in his ordinary
recreations. He is alert and irritable with those
about him at times ; but, in general, his actions are
slower than formerly, and it is apparent that his

Danger Signals 73

mind works with corresponding tardiness and dif-
ficulty.

His intellect is still intact, but the flow of
thought is noticeably retarded, and his whole atti-
tude is one of dull apathy. More than likely he
will become careless about his dress and appear-
ance — a most significant symptom. And as there
is a sluggishness of bodily functions, he is hkely
to have digestive disturbances.

If the person showing these symptoms has hith-
erto been of cheerful, buoyant disposition, the
change in his condition is quickly noticed. This
change is less apparent in those who are naturally
quiet, reserved, or seclusive. Yet in either case
the symptoms are important danger signals which
demand active interference and correction if the
sufferer is to be saved from actual insanity. If
such correction is undertaken at once, however,
the chances for recovery without any perceptible
mental deterioration are favorable.

We need not, for our purpose here, picture the
next stage of mental deterioration. But it is of
vital importance to know that at this initial
stage, if the patient is given proper surroundings,
with the right kind of physical and mental
hygiene, that the graver calamity can be averted
in a majority of cases.

It should not be understood that all cases of
incipient melancholia exhibit the' symptoms of
approaching derangement in the order just out-

74 Increasing Your Mental Efficiency

lined. In some instances peculiar delusions and
hallucinations manifest themselves early in the
attack. The sufferer may believe that he has per-
petrated frauds, ruined his health, betrayed his
friends, or committed an unpardonable sin for
which there is no hope of forgiveness. Or he may
fancy that he sees disagreeable sights, is convinced
that all the food offered him is poisoned, or hears
voices calling to him, commands from the Deity,
or temptations by the devil. In this state of hope-
less distress he may commit suicide or attempt
the destruction of the members of his family " to
save them ' ' — an example of the illogicality of his
distorted reason.

But when any of these symptoms are exhibited
early in the attack, although they indicate a con-
dition less favorable to ultimate recovery, they
usually attract the attention of the friends, and
thus insure early, and perhaps curative treat-
ment.

Brain Cells That Are too Active

Curiously enough a condition similar to the one
just described sometimes alternates with one in
which the main symptoms both physical and men-
tal are of an exactly opposite type. Exaggerated
bodily activity, exalted feelings of euphoria, and
a rapid flow of ideas rather than a retarded train
of thought, are the curtain raisers for the tragedy.

Danger Signals 75

These may be simply an exaggeration of a normal
condition, and if so are likely to remain unnoticed
for a longer time. The patient is verbose and
talks in a mildly exalted manner to every one
about him; he is ceaselessly active, busying him-
self with trifles and dabbling in first one thing
and then another, writing numerous letters on un-
important subjects to chance acquaintances, chang-
ing rapidly from one diversion to another, making
witty remarks, puns, and jests, retailing funny
anecdotes, and showing a sense of well-being
not unlike the general effects of mild alcoholic
intoxication. Indeed this condition is fre-
quently mistaken for mild inebriety, particu-
larly in those who are addicted to alcoholic ex-
cesses.

These patients exhibit also peculiar irritability
and petty animosities, sometimes seeking contro-
versies without provocation or reason; and al-
most invariably they exhibit peculiarly resistant
insomnia.

The condition is, indeed, a true ' ' intoxication ' '
in the medical sense. But it should be borne in
mind that this kind of intoxication differs from
that produced by alcohol or drugs in that it never
begins or ceases suddenly. Almost invariably the
person shows slight abnormalities for some time
without arousing the suspicion, or apprehension,
of his friends. And curiously enough the general
character of this initial abnormality is usually

75 Increasing Your Mental Efficiency

that of mental depression — precisely the opposite
condition to the one now exhibited.

The immediate friends will frequently recall
that the sufferer had been given to brooding for
some time, and in many ways has shown gradually
increasing inaptitude or incapacity for work.
They may have observed, also, a tendency to re-
vert to a condition of depression (which is gen-
erally far less pronounced than in actual melan-
choha), after a certain period of the exalted
condition just described. Indeed, alternation of
these two conditions is characteristic of certain
forms of insanity.

The mild condition of exaltation, or depression,
just described is only the prelude to the more
serious catastrophe. But from our present point
of view it is by far the most important stage.
For in this condition, which at worst should only
be regarded as a state of hypomanic excitement,
rather than actual insanity, the case is amenable
to curative treatment.

It is peculiarly desirable, therefore, that every
person should have a reasonably clear working
knowledge of the significance of these danger
signals, and realize the importance of heeding
their warnings before it is too late. We need
not picture the symptoms of the later stage. The
frenzy of the maniac has been so frequently de-
scribed in every field of literature that it is
familiar to every one. Once this stage is reached

Danger Signals 77

the mental hygiene of the home is entirely inade-
quate. So also, we admit regretfully, is any other
known form of treatment in a vast majority of
cases.

One of these two conditions of exaltation or
depression with their somewhat characteristic
premonitory signals of mental waverings, char-
acterize the initial stages of the majority of men-
tal aberrations. There are other forms, however,
in which the signals are so obscure, or that are so
closely akin to temporary exaggeration in normal
mental states, that they are less likely to be
recognized.

It was said a moment ago that persons who
are odd, eccentric, and have so-called " artistic
temperament," frequently show a mild degree of
maladjustment to their surroundings. We may,
indeed, make the statement somewhat more com-
prehensive. Persons who develop that peculiar
form of mental aberration called paranoia, — the
class from which the calculating assassins are
drawn — have usually been odd, eccentric, or ' ' tem-
peramental " from childhood. Knowing this, it
is readily understood why any parent who en-
courages eccentricity in his child, or any adult
who purposely exaggerates or fails to restrain
his own eccentricities, is courting ultimate dis-
aster.

78 Increasing Your Mental Efficiency

The Significance of Eccentricities

The man who goes bare-headed in societies
where the custom of wearing hats is universal;
the man who wears flowing locks in cropped haired
communities; the freak who dresses in Greek
robes, or goes barefooted in a leather-shod world
— each of these is treading a dangerously narrow
borderline. For such unusual actions of noncon-
formity demonstrate an exaggerated egoism — a
false estimate of one's own importance and mal-
adjustment to surroundings, that keeps the trend
of mentality in the general direction of the asylum.
I say asylum, rather than hospital: for no case
of true paranoia ever recovers.

This disease is the result of delusions acting
on a mind having a constitutional taint — an in-
heritance that may have been developed by bad
training in childhood. Yet paranoiacs are fre-
quently persons of unusual intelligence. They are
the victims of delusions that tend to become sys-
tematized — that is, the delusions arrange them-
selves sequentially in support of a fixed idea, ia
a manner that can be logically explained by the
victim, although obviously grotesque to others.
Unfortunately, this idea is usually unpleasant in
character, a delusion of persecution.

The disease is likely to begin about the time
of puberty, and as its development is slow, may
not be detected for several years. A very com-

Danger Signals 79

mon symptom in the beginning is a suspicion on
the part of the victim that there is something
queer in his personal appearance, and that people
stare at him. He imagines that persons who pass
him, turn and look at him, and he suspects that
groups of persons are talking about him, criticis-
ing, and later, plotting against him.

He is unhappy, and feels himself out of har-
mony with his surroundings and fellow men.
He feels that "he is not understood "; and fre-
quently his idioscyncrasies are mistaken for
marks of genius. And so they may be. But these
" misunderstood " individuals are much more
likely to be paranoiacs than genuises.

Unlike the unhappy melancholiac who blames
himself for his unhappiness, the paranoiac blames
others for his misfortune. To the melancholiac
the world is right, himself wrong : to the paranoiac
the world is all at fault.

With this attitude of mind, then, he sees things
in strange relations. For that matter, so does
genius. But the genius proves his title by turn-
ing his unusual insight to practical account, while
the visions of the paranoiac come to nothing ex-
cept disaster.

The mind of the paranoiac is clear, and may be
even brilliant. Thus the disease is not one of
clouded intellect as in some other forms of aber-
ration, but rather a condition of faulty judgment.
Frequently these paranoiacs show great logicality

8o Increasing Your Mental Efficiency

in reasoning from eertaia premises on many sub-
jects; but their shortcomings lie in their false
judgment of themselves, and their abnormal sus-
picion of the motives of others.

A few years ago I witnessed a series of amus-
ing episodes which illustrate the characteristic
paranoiac attitude of mind. Two farmers of my
acquaintance were joint owners of a valuable stal=
lion. One of these men was a typical hard-headed
Yankee, the other a man with a distinctly para-
noid type of mind. As some disagreement had
arisen about the care of the animal, the para-
noiac-partner offered to sell his share in the
horse.

The Yankee considered the proposition for a
few minutes, and then expressed his willingness to
buy, offering two hundred and fifty dollars for
his partner's share.

Now this was a perfectly fair valuation, and an
amount that the other partner would have been
glad to accept — ^until it was offered. But the
moment his partner expressed his willingness to
buy he became suspicious. He reasoned thus:
This man has made me the offer because he knows
that he can sell the horse for more. Why should
I not get the benefit of this profit, too ? My part-
ner is trying to cheat me.

All this, be it understood, was not thought out
on the spur of the moment, but after several days
of careful consideration. Then he sought his

Danger Signals 8i

partner and flatly refused the offer, intimating
his reason for refusing.

" Very well, then," said the partner, " I'll sell
you my half interest for two hundred and fifty
dollars. ' '

A chance to buy was the very thing that the
suspicious partner was now seeking. But the mo-
ment the chance was offered he demurred. After
all, he thought, his partner would not be so anx-
ious to sell unless there was some very good
reason for doing so. Something was wrong with
the horse ; or the former offer to buy was simply
a blind to wheedle him into buying instead of
. selling. And so, after brooding over the matter
for a day or two he decided not to buy, just as he
had decided not to sell.

Now in a general way the reasoning of this sus-
picious partner was closely similar to the usual
circumspection necessary to carry out any careful
business transaction. But the subsequent events
showed that the suspicious partner's attitude of
miad was abnormal. For at the end of three
years of intermittent haggling back and forth,
during which time almost every conceivable kind
of give-or-take offer was made and refused, there
had been no change in ownership of the horse.
Then the animal itself settled the matter by dying
of pneumonia.

82 Increasing Your Mental Efficiency

The Goal of False Suspicions

The characteristic thing about this paranoiac's
attitude was that his arguments were perfectly
logical, and might very well be founded on facts.
This attitude of mind typifies paranoia in the be-
ginning; frequently the delusions of persecution
are founded on facts. But in cases in which the dis-
ease is destined to develop into paranoid insanity,
this need not be so, and frequently is not. Many
of the fancied wrongs are of a purely imaginarj'-
nature, perhaps a single focus in the beginning.
But by adding and magnifying one fact here, and
another there, always giving it the ' ' squint ' ' that
makes it fit into the general scheme of persecuting
thought, the paranoiac weaves an unbroken chain
of evidence to support his false premise.

The danger mark in true paranoia is when hal-
lucinations make their appearance, hallucinations
that usually manifest themselves as imaginary
voices almost without exception threatening, or
bidding the patient do some violent deed. Thus
the voices may seem to come from enemies, or may
come as messages from God commanding the
death of a king, or a president. In either event
they are likely to result in violence, such as the
assassinations of a Garfield, a McKinley, or a
King Humbert. Yet the overt act seems entirely
justifiable to the paranoiac, to whom the halluci-
natory voices are absolutely real.

Danger Signals 83

It does not follow, of course, that every para-
noiac who has delusions of persecution, as prac-
tically all of them do, will eventually conunit some
violence. There are many of these unfortunates
who bear a cross, not a weapon. But there is al-
ways danger that the. burden of the cross may
become intolerable, and a spirit of revenge replace
the one of humble submission.

It is important to remember that the signs of
approaching, or threatened, paranoia are fre-
quently apparent to the immediate relatives and
friends of the afflicted person long before an out-
sider, unfamiliar with his normal conduct, would
suspect it. When such symptoms are detected,
active measures should be taken immediately to
try and correct them ; for if the disease progressed
to the stage of hallucinations, it is practically im-
possible to check its progress.

Despite the fact that the violent paranoiac is
the most dangerous type of lunatic because of his
logicality and apparent normality of thought, a
vast majority of the milder types of paranoiacs
remain at large in their communities. Frequently
they are regarded as queer or eccentric persons.
Many of them are unable to hold positions for any
length of time, because they believe that their as-
sociates persecute them in various petty ways.
They imagine that their mail is tampered with,
that other employes complain of them to their em-
ployers; or they suspect that misplaced articles

84 Increasing Your Mental Efficiency

have been purposely concealed to annoy them.
Sooner or later they take their troubles to their
employers; and frequently the reassurance they
receive quiets their suspicions for the moment.
For the paranoid type of person usually performs
Ms tasks with great proficiency; and for this rea-
son is likely to be in good standing with those for
whom he works. But the effect of the employer's
reassurance soon wears away, the ideas of per-
secution again dominate the diseased mind, and
in the end the paranoiac leaves his position and
seeks employment elsewhere'.

Of course his persecutors do not confine their
efforts to his place of business, but carry their
activities to the home or boarding-house of the
victim, and follow him to his new place of employ-
ment. He sees evidences of their influence in his
places of amusement and on the street, in the hun-
dred and one petty annoyances of everyday life.
And so the unfortunate goes about in an atmos-
phere charged with dismal suspicions — a maze
of tangled mysteries which center about himself.
These are the men who are forever in litigation —
righteous litigation in every instance in their
honest opinions. And these are the patients who,
when committed to the asylums, secure habeas
corpus hearings, conduct their own cases in court,
and are forever convincing lay jurors that they
are sane and should be liberated because of their
ability to reason with such apparent logicality.

Danger Signals 85

Eventually they drift back into the insane hos-
pitals again; but unfortunately this return may
be deferred until their delusions have driven them
to commit some frightful crime. In that event it
is often the electric chair, rather than the asylum,
that closes the dismal chapter.

The less pronounced types wander from one
place of employment to another, and from one
place of abode to another, always seeking to evade
their persecutors, but forever jfinding them haunt-
ing each new environment. As a rule they are
great faddists; and this faddishness may be the
first symptom that excites suspicion of their men-
tal abnormality.

Narcotics and Mental Stability

There is one quite common danger signal in-
dicative of a somewhat unstable nervous make-up
that every individual can gauge, and should heed.
This is the effects of alcohol. Persons who are
abnormally sensitive to small quantities of alco-
holic drinks have less stable mental equilibrium
than those who are not affected by reasonable
potations. And persons of this peculiarly sensi-
tive type should avoid alcohol in every form, and
should practice mental hygiene, at least to the ex-
tent of avoiding the better known dangers to men-
tal equilibrium, such as bursts of anger, brood-
ing, and tendencies to despondency, or excesses of

86 Increasing Your Mental Efficiency

any kind. For their idiosyncrasy is most sig-
ficant.

Besides these individuals, there are many per-
sons whose inherent mental tendencies may be
judged by the effect that alcohol produces upon
them. In a general way, all persons fall into one
of two classes. One of these includes the persons
in whom alcohol produces an extreme degree of
exhilaration — who become " crazy," and entirely
irresponsible after a few drinks. The other (and
a far larger class, I believe) do not experience the
same exhilaration, even with copious imbibitions
— cannot, in short, " drive away all oare " with
liquor.

Of these two types, the person who is more
easily affected and becomes highly exhilarated by
alcohol, is likely to be of a more unstable, or
neuropathic make-up. This is shown in another
way. Such persons are much more likely to be-
come addicted to drugs, since drugs have the same
peculiarly exhilarating effects upon them. The
type of person not unduly exalted or excited by
alcohol is usually more phlegmatic and more
stably balanced, and less likely to become the vic-
tims of narcotics.

There is one hopeless form of mental aberration
for which no curative treatment can be given, even
if the initial symptoms are detected early. This
form of insanity is called paresis. The course of
this disease is usually rapid, and death inevitable

Danger Signals 87

within a comparatively short time. But, even
though a detection of the early symptoms will not
avert the ultimate calamity, it is highly important
that such symptoms be recognized, since these
patients tend to do things that are likely to bring
disaster upon their households as well as them-
selves.

It seems paradoxical that this most incurable
form of mental aberration is the most preventable
— is, indeed, the result of the specific disease,
syphilis. But fortunately it does not develop as a
common sequence of this infection, although there
is every reason to beheve that there is no case of
paresis that is not preceded by syphilis, either
hereditary or acquired. Not every person who
has contracted, or inherited, a specific infection —
perhaps not over one in one hundred — will become
paretic. And in any event, even the initial symp-
toms of this disease will not appear until several
years after the specific disorder.

" The most suspicious of all circumstances,
which may indicate the inception of general pa-
ralysis (paresis)," says Hollander, " is a gradual
but obvious alteration in the mental character-
istics of the individual." There may be also an
alteration in the patient's physical system which
may give definite indications of disease quite as
pronounced as the mental symptoms.

The most frequent and characteristic mental
change is a general state of mild exhilaration,

88 Increasing Your Mental Efficiency

quite unlike the patient's usual state of mind. He
expresses himself as being in perfect health —
never felt better in his life. And the expression
of his face shows a pleased satisfaction with him-
self, which may continue for months without
other very pronounced mental changes. Mean-
while, however, his family may have noticed that
some peculiar and entirely unusual physical
symptoms have developed. There are tremors
of the Ups and tongue, with accompanying diffi-
culties in speech when attempting to pronounce
certain words, and the handwriting may change
entirely and become almost illegible. The patient
is likely to be irritable over small matters, make
unusual demands of those about him, and whim-
sical about his food. Yet all this time he asserts
insistently that he is feeling better than ever
before.

This feeling of well-being, which characterizes
most cases, does not always accompany the other
symptoms. Some paretics are depressed; and
even the elated states are likely to be interspersed
with periods of depression, or moroseness. But
the physical symptoms are fairly constant, and
even the tremulous, depressed patient may have
delusions of grandeur completely subversive of
his physical condition. He asserts that he is the
strongest man in the world, the most skilful, and
the richest, even though penniless and infirm.

It is a peculiar feature of the early symptoms

Danger Signals 8g

of this disease that the patients are likely to enter
into extravagant business ventures, which leave
their families penniless later on. They are prone
to conceive stupendous undertakings, such as buy-
ing or manufacturing articles on an enormous
scale. And, if they have been successful in busi-
ness ventures hitherto, the visionary nature of
these schemes may escape detection, until too late
to avert the fatal crash and resultant ruin.

The moral sense is usually dulled rather early
in the disease. The patient may perpetrate frauds,
or actually steal things for which he has no use;
and detection causes him no remorse. Eventually
he becomes careless of his personal appearance,
and in his deportment, even though formerly most
exemplary in such matters. But by the time this
stage is reached his mental abnormality will cer-
tainly have been detected. Let us hope that this
detection has not been delayed until this doomed
man has dragged his friends into ruin with
him!

Some of the visionary schemes of these paretics
are presented with such logicality, that they defy
controversion except by the dictum of common
sense. I knew one patient who conceived a gigantic
scheme for making a million dollars yearly profit
by raising " white navy beans." Beans would
bring one dollar a bushel ; an acre of ground will
produce two bushels ; the cost of production is not
over one dollar per acre. Ergo: rent a million

go Increasing Your Mental Efficiency

acres of ground, raise two million bushels of
beans at a cost of one million dollars; sell the
crop for two millions ; and clear a million. What
could be simpler!

Stated thus, the scheme is too obviously gro-
tesque for consideration. But as presented by the
patient it was most convincing. For he could
give a logical explanation to every possible objec-
tion, or apparent obstacle, and meet them with an
array of figures seemingly unanswerable. Some
less patently fantastic, but no less visionary
scheme, has brought financial ruin upon many a
paretic and his unsuspecting friends.

Transient Mental Waverings

Closely allied to the insane states, and fre-
quently merging into them, are abnormal mental
conditions which, in their milder manifestations,
have been experienced by every one. I refer to
perverse obsessions, such as a desire to do, or say,
things suggsted by some compelling impulse — im-
peirative conceptions, as they are called. The
normal mind resists such impulses. But neuro-
pathic persons sometimes find great difficulty in
suppressing them, particularly when in a state of
high nervous tension, or exhaustion.

A recent writer on this subject describes these
persons as " feeling an irresistible desire to tell
persons they see to do some harm; if they see a
child, to tell it to break things or set the place

Danger Signals gi

on fire. Ruffianly looking men give rise to the
desire to tell them to kill or to do some harm.
These imperative conceptions are often associated
with a feeling of doubt as to their having per-
formed some act; thus they often doubt if they
had told these persons to do harm."

These are the words of a modern psychiatrist.
But nearly three quarters of a century ago this
condition was described by a writer of fiction in a
manner that leaves no room for improvement.
The description occurs in Hawthorne's Scarlet
Letter, and shows the author's marvelous insight
into the abnormalities of the human mind. Few
physicians in Hawthorne's time had any such
clear understanding of this peculiar mental phe-
nomenon : none to-day has any better. Indeed the
terse description given above could have been
drawn from Hawthorne's masterful delineation.

The incident in the Scarlet Letter which inspired
this description is the one in which the erring,
but unsuspected and revered minister, Mr. Dim-
mesdale, has just reached the determination to
throw off the oppressive secret yoke that had shat-
tered his body and set his mind tottering.

" At every step he was incited to do some
strange, wild, wicked thing or other," runs the
description, ' ' with a sense that it would be at
once involuntary and intentional, in spite of him-
self, yet growing out of a profounder self than
that which opposed the impulse. For instance, he

92 Increasing Your Mental Efficiency

met one of the deacons. The good old man ad-
dressed him with the paternal affection and pa-
triarchal privilege which his venerable age, his
upright and holy character, and his station in the
church, entitled him to use; and, conjoined with
this, the deep, almost worshipping respect, which
the minister's professional and private claims
alike demanded. Never was there a more beauti-
ful example of how the majesty of age and wis-
dom may comport with the obeisance and respect
enjoined upon it, as from a lower social rank, and
inferior order of endowment, towards a higher.

" Now, during a conversation of some two or
three moments between the Reverend Mr. Dim-
mesdale and this excellent and hoary-bearded
deacon, it was only by the most careful self-control
that the former could refrain from uttering cer-
tain blasphemous suggestions that rose into his
mind, respecting the communion supper. He ab-
solutely trembled and turned pale as ashes, lest
his tongue should wag itself in utterance of these
horrible matters, and plead his own consent for
so doing, without his having fairly given it. And,
even with this terror in his heart, he could hardly
avoid laughing, to imagine how the sanctified old
patriarchal deacon would have been petrified by
his minister's impiety.

" Again, another incident of the same nature.
Hurrying along the street, the Eeverend Mr. Dim-
mesdale encountered the oldest female member of

Danger Signals 93

his church, a most pious and exemplary old dame,
poor, widowed, lonely, and with a heart as full of
reminiscences about her dead husband and chil-
dren, and her dead friends of long ago, as a burial-
ground is full of storied gravestones. Yet all this,
which would else have been such heavy sorrow,
was made almost a solemn joy to her devout old
soul, by religious consolations of the truth of the
Scripture, wherewith she had fed herself con-
tinually for more than thirty years. And since
Mr. Dimmesdale had taken charge, the good
grandam's chief earthly comfort — which, unless
it had been likewise heavenly comfort, could have
been none at all — was to meet her pastor, whether
casually, or of set purpose, and be refreshed with
a word of warm, fragrant, heaven-breathing Gos-
pel truth, from his beloved lips, into her dulled,
but rapturously attentive ear.

" But, on this occasion, up to the moment of
putting his lips to the old woman's ear, Mr. Dim-
mesdale, as the great enemy of souls would have
it, could recall no text of Scripture, nor aught else,
except in brief, pithy, and, as it appeared to him,
unanswerable argument against the immortality
of the human soul. The instillment thereof into
her mind would probably have caused this aged
sister to drop down dead, at once, as by the effect
of an intensely poisonous infusion. What he really
did whisper, the minister could never afterwards
recollect. There was, perhaps, a fortunate dis-

94 Increasing Your Mental Efficiency

order of his utterance, wMeli failed to impart any
distinct idea to the good widow's comprehension,
or which Providence interpreted after a method
of its own. Assuredly, as the minister looked
back, he beheld an expression of divine gratitude
and ecstasy that seemed like the shine of the celes-
tial city on her face, so wrinkled and ashy pale."
Some similar attitude of mind, in a less exag-
gerated form, — some imperative conception, in
one form or another — is likely to obsess the highly
strung, over-wrought normal person. It is usually
suppressed and soon forgotten. But it is a danger
signal — a red light signal of impending disaster,
if you please — ^which should be heeded and cor-
rected. Yet unlike many of the others just enum-
erated, its detection and correction rest almost ex-
clusively with the individual himself. His actions
may finally reveal his obsessions to his friends;
but the time for correction is before this — ^before
his mentality succumbs to such a degree that he
cannot resist acting on the impulse created by the
impelling thoughts.

IV

Nourishing the Mind

A MERICA is a country of enthusiasts. And
■^*- enthusiasm is undoubtedly a valuable na-
tional asset. But great enthusiasm about too
many subjects indicates a somewhat faulty judg-
ment in many instances — a type of credulity that
leads to the chasing of one phantom after another
without any very definite accomplishment.

There is no nation in the world that has so little
cause to worry over what it eats as our own ; yet
no country is so obsessed with diet-fads. Break-
fast-food fads, and chewing fads, carry us off our
feet in mad enthusiasm — at least until some other
tempting fad crosses our path, and turns us into
fresh channels of pursuit.

Fortunately for ourselves we are not persistent
in our fad-chasing, so that no great amount of
harm results from our escapades. Indeed most of
the fads are so innocuous in themselves that they
would do little harm if pursued persistently. But
occasionally one is created that would prove dis-
astrous to its votaries if pursued too persistently.

Some one has said, and with a great deal of
truth, that if " they [the food faddists] were not

95

96 Increasing Your Mental Efficiency

busy chasing one fad they would be busy chasing
another." They are, in short, faddists chroni-
cally, and by nature. But the recent episodes in
our last-but-one-or-two eating fads, " Fletcher-
ism," demonstrates that few persons are entirely
immune to the influence of well-aimed faddism.
For this fad draws a horde of usually well-bal-
anced persons into the vortex temporarily — per-
sons who should have known that any fad which
attempts to overthrow estabhshed customs in eat-
ing, sleeping, or clothing ourselves by radical
changes in methods, will be ephemeral.

The history of the beginning of Fletcherism is,
briefly, as follows: Mr. Horace Fletcher, an
American gentleman, middle-aged, fat, dyspeptic,
and in a generally demoralized physical condition,
hit upon the idea of self -cure by eating less food
and chewing that small quantity mouthful by
mouthful many more times than is usually con-
sidered necessary for proper mastication. There
was really nothing novel in the essential features
of this " cure." Even the ancients knew that
middle-aged men in easy circumstances usually
eat too much and chew too little. And in more
recent times Gladstone had set the example of
better food mastication by making it a rule to
" give every tooth a chance " — thirty-two masti-
cations to each mouthful.

But Gladstone was a man busy with so many
things that he did not ride his chewing hobby to

Nourishing the Mind 97

the exclusion of all others. With Mr. Fletcher the
case was different: he had but one hobby in his
stable, and he focalized his equestrian feats upon
that one. Moreover, he was no ordinary rider.
He had no goods to sell — ^no new kind of break-
fast-food to foist upon the guileless and gullible —
simply a philanthropic and entirely worthy pur-
pose to tell the world a great discovery that
would make the world much better. The principle
of the new fad was simply to eat Uttle food,
but chew it and chew it, and then chew it some
more, until it was tasteless and nauseating.
By such means weak men would be made strong,
and strong men stronger, on a mere pittance
of food.

As proof of this, Mr. Fletcher could point to
the great change for the better in his own physical
condition. And there is no denying that this
change was revolutionary. But there are two
vitally weak points in the evidence, which Mr.
Fletcher, lacking expert medical knowledge, could
not to be expected to appreciate. The first is, that
simply because the multi-chewing method had
cured one man it need not necessarily cure any
other man ; the second, what might indeed be very
good treatment for a sick man (as Mr. Fletcher
certainly was) might be positively harmful for a
well person.

gS Increasing Your Mental Efficiency

The Dangers of Diet Fads

Medical men learned many generations ago that
" one man's food was another man's poison,"
literally; and experience has taught them not to
found any hard and fast rules on the results of
experiments upon a single individual. Moreover,
as I shall show in a moment, our knowledge of
physiology, which surely cannot be completely at
fault, seems to show that Fletcherism could not be
a scientific cornerstone upon which to build a per-
fect health temple.

But " scientific caution " was singularly lack-
ing among the converts to the new fad, several
of whom were stamped into the herd from the
ranks of the medical men themselves. Some of
these were undoubtedly sincere, even if somewhat
too credulous. Others, we may strongly suspect,
were influenced by the prospect of getting aboard
a very well patronized and well advertised excur-
sion.

We need not chronicle the stream of adulatory
literature that the new fad called forth. An ex-
ample or two will suffice. One learned professor
wrote to the instigator of this stampede: " What
you have done to unfold physiological mastication
means more for human weal than all the mere
medical prescribers have given the world from
Adam to the present time! " A sanitarium
keeper carolled in this mawkish strain : ' ' We are

Nourishing the Mind gg

chewing hard at , chewing more every

day. . . . We have gotten up a little Chewing
song which we sing to the patients. ... I read
some of your notes to my colleagues, and they
were so much affected that tears came into their
eyes."

And yet, half a decade after this affecting,
lachrymose scene, Fletcherism was not only dead
as a fad, but was known to be a " physiological
monstrosity " instead of the great physiological
discovery. In the meanwhile it had demonstrated
from a somewhat unusual angle the well-known
fact that enthusiasm may play havoc with judg-
ment — even about such a prosaic thing as eating.

The Fleteherites overlooked some fimdamental
truths that should be self-evident. It should be
apparent to any intelligent person that it is quite
as impossible to create matter by chewing it, as
by any other known method. Moreover, the
amount of matter required for bodily nourishment
is much more than the Fleteherites advocated.
That much for quantity.

As to quality, every one knows that three kinds
of food are necessary to life: (1) proteids, rep-
resented by meats, fish, and eggs; (2) carbohy-
drates, such as the starch furnished by vegetables ;
and (3) fats, of one kind or another. What effect
does mastication have upon these various essen-
tials ? On the proteids it has practically none, the
digestion of these important kinds of foods taking

100 Increasing Your Mental Efficiency

place farther along in the alimentary canal.
Similarly, the fats are not influenced by mastica-
tion or ensalivation in the mouth to any very
great extent; while the starches are converted
into a form of sugar — g, necessary step to absorp-
tion of this form of food.

It would appear, then, that the advantages of
excessive mastication were appropriate and help-
ful, only when eating starchy foods. In short, one
might consistently bolt his meat, but must chew
his vegetable soup thoroughly, if his digestion is
to remain perfect. But Nature has made provi-
sion for toothless infancy and old age, and does
not place a very severe digestive task upon the
secretions of the mouth at any period of life. In-
deed, the important part in the digestive process
of those substances upon which the saliva acts in
a helpful manner, is carried on in the intestines
through the agency of a much more powerful and
active digestive ferment secreted by the pancreas.
So that prolonged mastication will, at most, simply
help to perform a digestive act in the mouth, with
its relatively ineffective mechanism, and thus re-
lieve an efficient organ, the pancreas, of a task
for which nature specially designed it.

Moreover it has been found by recent experi-
ments that excessive mastication may reduce the
food to such a degree of minute division that it is
not handled properly by the natural processes of
absorption. Like finely ground powder grains in

Nourishing the Mind loi

a great gun, it causes a premature explosion of
energy in a too circumscribed area, instead of
being distributed properly along the bore.

But all this is simply an explanation of why ex-
cessive mastication is an unnecessary, as well as
a somewhat disgusting practice. It offers no ex-
planation of why Fletcherism lost its popularity
as a fad. Yet such explanation is scarcely neces-
sary. The fact that it was simply a fad suffi-
ciently explains its decline in popularity : for such
is the fate of all fads. And, as regards this par-
ticular hobby, it was most fortunate. For if we
had actually carried out the plans of the Fletcher-
ites, and attempted to raise the younger genera-
tion of growing boys and girls by the regime of
chewing and parsimonious diet that had cured an
elderly and pathological gentleman, we should
have produced a race of sickly weaklings.

Value of Established Customs in Diet

Normally healthy persons should shun all eat-
ing-fads. For it is a clinical observation, trans-
mitted through many generations of physicians,
that faddishness about eating is a sure road to
dyspepsia. " The generalized food customs of
mankind," said Sir William Eoberts, " are not to
be viewed as random practices adopted to please
the palate or gratify an idle or a vicious appetite.
These customs must be regarded as the outcome

102 Increasing Your Mental Efficiency

of profound instincts which correspond to cer-
tain wants of the human economy. They are the
fruit of a colossal experience accumulated by
countless millions of men through successive gen-
erations. They have the same weight and signifi-
cance as other kindred facts of natural history,
and are fitted to yield to observation and study
lessons of the highest scientific and practical
value."

This being the case we should be able to find
some reason why we have formed the habit of
eating our meals with the various dishes served
in certain definite order, if it is not merely a
caprice of fashion or conformity. In short, why
we eat soup first and pastries last, instead of the
reverse.

Some recent investigations offer an entirely
satisfactory explanation for doing so, on physi-
ological grounds. According to a recent writer,
" we have unconsciously established a routine of
courses in the dinner that takes thorough cog-
nizance of the physiological principles upon which
digestion is founded. Even such matters as fes-
tive attire, floral decorations, and music, we are
told, have their share in composing a generally
favorable stage-setting, as it were, for digestion;
for it has been abundantly shown in recent years
that a person's mood is of the greatest significance
in the performance of the digestive functions."

This last fact should be borne in mind in seek-

Nourishing the Mind 103

ing a reason for the undoubted success of Fletch-
erism in some instances. The faddist is an enthu-
siast, for the time being at least, and undoubtedly
in many instances his mood rather than his method
accounts for the beneficial results.

Why Soup Precedes Pastry

But to return to the physiological reason for
the order of our meals. Dr. Leverson's explana-
tion of the logicality of having the dessert course
composed largely of carbohydrate preparations —
pastry, sweets, fruit, flavors, and cream — is en-
Jightening. " Foods of this order, as is well
known, are not primarily digested by the gastric
juice, but are acted on by the salivary ferment
known as amylopsin. This ferment is incor-
porated with the food in the mouth, and will con-
tinue to act until it is neutralized by the gastric
juice. It was formerly assumed that such neu-
tralization must take place almost immediately
on the swallowing of the food. Eecent studies
discredit this view, it being alleged that the food
last ingested occupies a central position in the
stomach for some time, and that only the periph-
eral portions are actively in contact with the
gastric juice.

** Thus the carbohydrates that make up the des-
sert are so placed as to be acted on advantageously
and for a long period by the salivary ferment in-

104 Increasing Your Mental Efficiency

corporated with them; whereas had the same
foods been ingested early in the meal they would
have been brought at once in contact with the pe-
riphery of the stomach, and their digestive changes
arrested."

Here is another reason, then, why persons in
health should not be too ready to disregard es-
tablished customs in eating. Of course the case
is entirely different when there is organic bodily
disease. In such conditions, clinical and labora-
tory experiences of competent observers must be
the guide. But this guidance should be entrusted
to a thoroughly competent and trained observer,
and under no circumstances should self-guidance
be attempted. No person who is actually ill
should attempt to prescribe for himself in the
matter of diet any more than in kinds of medicine.

We may feel sure that there is a sound physio-
logical reason for the dietary differences that
exist between widely separated communities, such
as those at the equator, and those living near the
Arctic circle. There is conclusive evidence of this
in the fact that persons who visit these regions,
and remain for any considerable time, find it ad-
vantageous to adopt the food, and food customs,
of the natives. The people of any community,
taken collectively, choose the proper kind of foods
best adapted to their needs, guided by an instinct
created by experience. Individually there are
marked exceptions to this, particularly in highly

Nourishing the Mind 105

civilized communities. This last is, indeed, re-
iterating the statement that "one man's food is
another man's poison " — in individual cases only,
however. Taken collectively, one man's food is
another man's food. And it is better to follow
established customs than to attempt to overthrow,
or disregard them.

The perennial fad of vegetarianism is a case in
point. The life of this fad seems to be perpetuated
by the application of the sophistic rule that what is
food for certain individuals is food for the race.
There are certain healthy persons who live and
thrive on a vegetable diet; and there are patho-
logical conditions in which a careful vegetable
diet undoubtedly prolongs life.

Vegetables and Mental EfHciency

It may be pointed out with entire truthfulness
that vegetables contain all three of the essential
food elements — proteids, carbohydrates, and fats.
To be sure these elements are not offered in
ideal proportions for the use of our systems ; but
the human organism is such a wonderfully adapt-
able mechanism that it will select out the right
proportions for itself if supplied with sufficient
quantities. The system will " keep up steam " on
this bad fuel, just as a boiler can be made to steam
Avith poor coal. But if a bad quality of coal is
used, there must be more stokers and more labor.

io6 Increasing Your Mental Efficiency

which is poor economy. Moreover, poor fuel
tends to foul the boiler and shorten its life.

A purely vegetable diet makes poor fuel for the
human engine. Yet by putting on extra " stok-
ers," in the form of expended vital energy, this
poor fuel will keep the body machinery running.
As a result, however, the system expends vital
energy for the somewhat lowly purpose of stoking,
which might otherwise have been utilized for much
higher fields of creative work, both mental and
physical.

It is a significant fact that meat-eating races
lead the world in everything — war, commerce,
science, and art. The relative positions of the
Orient and the Occident exemplify this. The
Orientals consume far less meat than the people
of Europe and America, partly from necessity,
and partly on account of religious belief. And for
centuries they have lagged far behind the Euro-
peans in progress, and in war.

Japan is making a strong bid to become the one
exception among Eastern nations. In the arts of
peace she is certainly climbing to a high level;
and the recent war with Russia demonstrates what
she can do in war. But is she doing these things
on a vegetarian diet as of old? Not at all. Her
fighting seamen received the same proportion of
proteid foods in proportion to their body weight
as the British tars ; and her soldiers, in her recent
conflict with Eussia, " had a more abundant pro-

Nourishing the Mind 107

teid diet than any other army in the field has
ever enjoyed."

Thus we see that Japan offers no exception to
the rule that meat-eating races are the leaders
physically and mentally. And this suggests an
answer to the question which is frequently asked,
and which concerns us principally in this chapter,
as to what foods are " brain foods " if we may
use the term. So far as we know, it is quite im-
possible to feed the brain except through the gen-
eral process of feeding the body. The old idea,
which still persists, that fish acts as a food for
the brain rather than the body, has no basis in
fact.

If the child during its early years has been
given proper training, its own instincts will be its
best guide in the selection of proper nourishment
later in life. Ill health, of course, frequently
causes caprices about eating; but this is quite
another matter.

Most children at the age of puberty develop an
appetite for meat, and at this period should be
encouraged to gratify it. Important, vital changes
are taking place in the system at that time —
changes that have a direct bearing upon future
mental, as well as physical states — that require a
full protein diet for their development. Later the
craving for meat will gradually subside, and a
well-balanced regime be established.

The question is asked frequently whether active

io8 Increasing Your Mental Efficiency

mental or physical exertion should be indulged in
immediately after eating. As a general rule it is
not advisable to do either one or the other shortly
after a meal ; but here again the habits of the in-
dividual must be considered. Some persons, even
athletes,, are accustomed to taking strenuous ex-
ercise regardless of meal time. Indeed some
vocations make this necessary. But we do not
find that persons following these occupations are
more subject to digestive disturbances than
others.

I once inquired about the eating habits of a
champion wrestler who was doing strenuous train-
ing for an important match. This athlete made it
his regular practice to take a hearty meal at noon,
and go at once to the gymnasium to wrestle with
his trainers. When I expressed astonishment at
this, and asked the athlete if he considered his
method a good one, he declared that he had always
found it so.

" How can I work if I don't eat? " he inquired.
And this was the key to his point of view.

Of course his theory was entirely wrong. The
food taken into his stomach fifteen minutes before
beginning his exertions would not be utilized to
furnish strength until several hours later. Yet
in practice his method seemed to work satisfac-
torily, judged by results.

We must not interpret this wrestler's methods,
however, as indicating that violent exercise im-

Nourishing the Mind 109

mediately after eating is advisable, for athletes
or others; but rather that a vigorous body fre-
quently overcomes by adaptation obstacles that
oppose rational hygiene. Possibly if the excessive
mastication votaries of parsimonious diet had hit
upon a method similar to that of this wrestler,
instead of their particular hobby, this sort of fad
would have become popular in place of chewing.
And then we should have had still another ex-
ample of mistaking physical adaptability for
physiological need.

It seems to be a perfectly natural thing for chil-
dren to take violent exercise regardless of the time
that food is ingested; and as no harm seems to
come from this it is not advisable to interfere with
this natural process by compelling the child to rest
after eating. The case is somewhat different as
regards mental effort. Children should not be
forced to study immediately after taking a full
meal.

This seeming paradox may be explained on
physiological grounds. Physical exercise is a
heritage handed down through countless thou-
sands of generations, and has established itself
as a natural process ; whereas close mental effort
is a recent iimovation and may, therefore, be re-
garded as an artificial one. When close mental
application to printed pages has become a natural
process through ages of indulgence, it is probable
that the children of that future age will be able

no Increasing Your Mental. Efficiency

to eat and study with the same impunity that they
may eat and play at present. But this result of
future evolution need not concern us now.

The rule that applies to children about mental
effort immediately after eating, applies also to
their parents; and for the same reason. But the
child's craving for protein food, and the neces-
sity for it, falls into another category. Adults of
sedentary habits should not indulge too freely in
a meat diet. There is a grain of truth in the
" vegetarian's " theory (as there must be in any
fad that gains a hearing) to the extent that many
persons of sedentary habits indulge too freely in.
a protein diet. In short, a necessity of childhood
may be a menace to old age.

The habit of overeating may be placed in the
same category, and may be explained on the same
physiological grounds. Normal children are in a
state of almost continuous physical activity, while
their minds remain relatively inactive. Adults
are prone to become slothful creatures physically,
with exaggerated mental activities — a condition
precisely the reverse of that in childhood. So that
there are substantial physiological reasons for re-
versing the methods of nourishing the individual
at these two periods of life. And practical results
demonstrate the soundness of the theory.

But this theory, like many others, should be in-
terpreted only on broad general lines. A finical
anxiety about the kind or quantity of food to be

Nourishing the Mind iii

eaten is quite as harmful as gross carelessness in
the opposite extreme. A healthy person should
think little about his food, either before or after
eating. Too close scrutinizing is likely to be the
gateway to hypochondriasis.

Stabilizing the Faculties

THERE is no one, short of the actual imbecile,
who does not appreciate that mental stability
is a valuable individual asset. But I think very
few persons fully realize what a terrible calamity
the shaking of that stability really is, largely be-
cause most people have given the matter very
little thought. If we pause and consider even for
a moment what permanent mental incapacitation
means, however, I think that any one will agree
that death itself is relegated to a minor position
by comparison.

Nothing approaching full compensation can be
returned for the toll taken by death. Yet it is
possible for every man to make such provision
against the ravages of the Grim Reaper, through
the medium of insurance, that his loved ones will
not be lacking in material comfort, if he is sud-
denly taken away. But no insurance can be taken
out to compensate for mental unsoundness.

Moreover, the person who becomes insane not
only ceases to be a provider, but himself becomes
a dependent burden. So that his incapacitation
represents a loss more disastrous than actual de-

112

Stabilizing the Faculties 113

raise, because it may add many years of continu-
ous incumbrance to his relatives.

It is evident, therefore, either from a selfish
standpoint or an altruistic one, that the mainte-
nance of mental stability is a great desideratum.
Nor is the quest a hopeless one, even among those
predisposed to mental unsoundness. For fully
half the cases of disturbed mental equilibrium are
preventable.

Every one knows how easily the vertical position
of a rolling hoop is maintained by a slight touch
on one side or the other just at the moment when
it begins to waver, but how impossible it is to
avert the fall once the hoop is deflected beyond
a certain point. Just so with mental equilibrium.
A deft touch here and there at the right moment
will keep the mental mechanism in a flexibly firm
" vertical position," as it were, and avert the
impending catastrophe.

One of the first and most constant symptoms of
threatened mental instability, is insomnia, or the
unrefreshing sleep that is frequently its forerun-
ner. It is a clinical indication in childhood, and
a danger signal later in life. At either period its
warnings should not be disregarded. We must
not, of course, confuse true insomnia with the
dreamy states that accompany over-sleeping, or
the habit of " slovenly sleeping " that is acquired
by some persons.

Sleep itself is still one of the great mysteries of

114 Increasing Your Mental Efficiency

life. And we are not able as yet to explain satis-
factorily just what mysterious mechanisms pro-
duce sleep, or its antithesis, insomnia. But we do
know very definitely the general effects of both
these conditions.

The Mystery of Sleep

' ' The marvel of sleep is lost upon us owing to
the unfortunate peculiarity that our ability to
wonder is soon abolished by mere repetition,"
says Dr. W. H. Thomson, " Because the recur-
rence of sleep is as certain and regular as sunset
itself, it does not occur to us to wonder at it, or
to ask what it all means."

We are certain that a change in the blood sup-
ply of the brain takes place during sleep, less
blood going to the head at that time than in the
waking hours. This may be demonstrated by
exactly balancing a person horizontally on a spe-
cially prepared tilting board. So long as the
person remains awake and motionless the balance
is maintained, but as he falls asleep the board
gradually tilts downward, showing that the blood
has been transferred from the head to the other
parts of the body. As the sleeper regains con-
sciousness the horizontal position is again as-
sumed as in the beginning of the experiment.

This, and other experiments, make it certain
that an anemic condition of the brain is produced

Struclurdl Changes in Mental Piscasas

The brain In, qeueraL paresis: M mental disease dependart

upoTL syphilid.

Tin essentialli/ noniuil hraui

Brain in general paresis.

Stabilizing the Faculties 115

during sleep, and probably the extent of this
anemia, or blood depletion, determines the pro-
foundness of the sleep, although this is by no
means certain. But for our purpose it suffices to
know that there is more blood circulating through
the brain during wakefulness, and less during
sleep, and we need not concern ourselves with the
nervous or chemical action that may produce these
conditions. I shall show in a moment why it is
important to understand this fundamental fact
in combating wakeful conditions.

We should distinguish very exactly between
true insomnia and certain " habits " of sleepless-
ness. Most persons who sleep badly do so be-
cause they have not learned to sleep properly, or
because they do not put their knowledge into prac-
tice. Many persons form bad habits of sleeping,
just as they do about eating or drinking. Some
sleep too little, others too much. Of the two faults
I believe the latter is the more common one, al-
though too little sleep is more harmful than too
much. The person who lies awake some little
time after going to bed, or lies in a half wakeful
state for any considerable time before getting up,
does so usually because he is trying to take more
sleep than he requires.

Such a person usually feels stupid on arising,
his mind does not work readily, and it may be
several hours before he feels himself to be keenly
awake. The normal feeling after a good night's

ii6 Increasing Your Mental Efficiency

sleep should be one of vigorous refreshment,
which continues throughout the day, with the usual
fatigue, but not exhaustion, at the end of the day's
work.

A condition of very different significance is that
of feeling exhausted in the morning, even after
an apparently good night's sleep, which is fol-
lowed by a feeling of well-being, or even exhila-
ration toward the end of the day. This condition
is pathological, and indicates that the system
is run-down and debilitated, and needs atten-
tion. For it may be the beginning of physical de-
pression, a condition that may be corrected easily
if taken in hand in the beginning, but which leads
to serious illness if neglected. Frequently it is
the result of nervous exhaustion, or mental agita-
tion.

One of the essentials of good sleeping is to make
a practice of going to bed as regularly as possible
at the same hour, and rising with a corresponding
regularity in the morning. In this way a correct
" habit " of sleeping is quickly formed. Our
bodies, like our minds, acquire habits very quickly,
and tend to retain them tenaciously.

As to the exact time of retiring, that must be
determined by each individual, for himself in ac-
cordance with his habits and walk of life. The
old rule, " early to bed and early to rise," is
useful only in the sense that its practice implies
regularity in sleeping. We may stamp as false,

Stabilizing the Faculties 117

also, the aphorism that " an hour's sleep before
midnight is worth two after midnight." For in
point of fact it is the number of hours of good
sleep that count, not the particular time at which
they are taken.

It is true, of course, that if a person goes to
bed at eight o'clock, his most profound slumber
will be taken before the middle of the night. For
the mind sinks quickly into its deepest uncon-
sciousness, remains so for three or four hours, and
then gradually approaches the conscious state.
But this cycle will be produced just as readily and
just as certainly, whether the hours be from ten
to six, or from one to nine. The advantages
of the earlier hours lie solely in the fact that
the distracting sounds of a busy world are less
likely to be a disturbing factor during the earlier
period.

We should remember that the rule about early
retiring was made in an age when night meant
darkness, and does not apply to the present age,
when gas and electricity have made the day
twenty-four hours long instead of twelve. More-
over, there are many persons — the majority of
adults in cities, at least — whose social or other
duties keep them up until midnight several nights
in each week. For such persons the rule about
retiring early would be made only to be broken
irregularly; and for this reason it is far better
for them to choose the later hour as the usual one

ii8 Increasing Your Mental Efficiency

for retiring. Indeed, it is advisable for any per-
son who is likely to be up until midnight two or
three nights in the week to make that time the
one for retiring regularly as a matter of habit.

Most people find it necessary (and it is cer-
tainly advisable) to arise at practically the same
hour each morning. If they make it a practice
to retire three nights in the week at twelve, and
three at ten, rising at their regular hour each
morning, they will obviously be sleeping too much,
or too little, at least half of the time. It is far
better to make the hour for retiring more nearly
imiform, particularly if there is a tendency to
sleep badly.

But six nights only account for the working
days of the week. What of the seventh?

A few years ago the Medical Record published
an editorial on " Blue Monday." In this the
writer exonerated Monday for any responsibility
in producing the proverbial " azure hue," and
placed the onus upon the foolish, unnatural, and
physiologically bad practices of the preceding
day — the * ' hang over ' ' effects of irregular sleep-
ing, of eating, drinking, working, and playing,
common to our Sabbath Day customs. If we
would conduct ourselves on Sunday as we do on
week days, the writer averred, ' ' Blue Monday ' '
would be striken from the calendar.

Stabilizing the Faculties iig

The Habit of Irregular Over-sleeping

A great majority of people make it a practice
to loll in bed on Sunday morning, thus disregard-
ing the established habits of the other six morn-
ings. If asked why they do this, many would
assert that they are " catching up " the sleep lost
during the week, thus attempting to correct in one
day the losses of six.

In point of fact this is seldom the real reason
for protracted sleeping, and this method would
not correct the fault if it were. For it is impos-
sible to force more than a certain amount of pro-
found sleep upon the brain — one cannot force him-
self to stay asleep as he can to keep awake. It has
been demonstrated repeatedly that the person who
stays awake seventy-two consecutive hours, let us
say, thus losing twenty-four hours of sleep, does
not " catch up " the lost hours by twenty-four
consecutive hours of slumber even if given abun-
dant opportunity to do so. Experiments have
shown that the average man will not take over
seventeen hours of sleep after the long period of
wakefulness, and thereafter require only his regu-
lar number of hours' sleep each night.

This suggests that the system is capable of in-
tensifying the quality of sleep to meet emergen-
cies. Indeed, this mysterious intensifying process
seems to be normal in some favored individuals,
who require far less sleep than most of their fel-

120 Increasing Your Mental Efficiency

lows, because their sleeping apparatus is more
efficient. Napoleon was an example, and Franklin
another. And undoubtedly it was this special
faculty of the American philosopher that led him
to make the rule for the number of hours required
for sleep as, ' ' six for a man, seven for a woman,
eight for a fool." But his standard is undoubt-
edly much too low, both for man and for woman ;
and the amount of sleep required by the fool is of
no consequence.

The implication that most persons sleep more
than is really necessary, however, is probably well
founded. But each individual is a law unto him-
self, and must determine for himself what his re-
quirements really are. If he stays in bed nine
hours and does not sleep soundly during all that
time, or is not refreshed and in vigorous men-
tality on rising, he is probably trying to force
more sleep upon his system than it requires. His
symptoms are proof of this. If he sleeps only six
hours, and does not feel himself completely re-
cuperated, he is being too parsimonious.

There is one form of insoronia which is char-
acteristic of a definite pathological condition, and
should be regarded with apprehension. It is char-
acterized by a period of wakefulness that comes in
the middle of the night to persons who are usually
good sleepers, and which follows a period of sound
sleep earlier in the evening. When such a thing
occurs repeatedly night after night without any

Stabilizing the Faculties 121

apparent cause, particularly in persons in middle
life or older, it is likely to be a symptom of high
blood-pressure which is the forerunner of or-
ganic disease. The persons with this symptom
should seek the advice of a physician at once.
For in this early stage it is quite possible to cor-
rect the sleeplessness by correcting the underlying
cause — which is vastly more important. Later on,
when organic changes in the blood-vessels have
actually taken place, it is impossible to correct
either the symptom or its cause.

Habitual dreaming is abnormal, although an
occasional dream can hardly be considered as an
abnormality. Too much food taken late at night,
too many hours of sleep, high mental tension and
worry, usually account for most dreams of the
occasional variety. When the dreams are fre-
quent and distressing, even when correct habits in
sleeping are rigidly practiced, some physical ab-
normality should be suspected.

Some confusion has arisen in the minds of cer-
tain persons as to whether it is a bad practice to
eat heartily just before retiring, since physicians
sometimes prescribe a glass of hot milk, or beer,
at bed-time to aid in inducing sleep. There need
be no confusion on this point, however, since the
effect of a glass of hot milk is very different from
that of a full meal. The glass of milk being easily
digestible does not tax the circulation except to
the extent of diverting enough blood from the

122 Increasing Your Mental Efficiency

head to aid in the mechanism of sleep production.
A full meal, on the other hand, sets the blood
pounding through the vessels, and tends to in-
crease, rather than diminish, the cerebral circu-
lation.

We know, of course, that there are thousands of
persons who habitually take a full meal before re-
tiring without experiencing any unpleasant re-
sults. But here again habit is a determining fac-
tor. In such cases the system has adjusted itself
to this untimely, but regularly ingested meal, and
is vigorous enough to counteract the effects of a
habit that is physiologically bad. In any event,
these exceptions do not vitiate the soundness of
the general rule against eating before retiring.

How Sleep May Be Induced

Persons engaged in mental work which does not
stop at the end of the ordinary working day with
the usual evening idleness or lethargy, frequently
find that the mental activity, with its flood of
ideas, continues when they cease work and attempt
to sleep. In such persons the sudden change from
active thinking to the exact antithesis, sleep, is
too great to be accomplished suddenly, without
some kind of " tapering off " process. Many
things suggest themselves for this purpose, but
the basis of all is really a change of vocation — a
mental " stepping down," diverting the mind into

Stabilizing the Faculties 123

less active channels, and thus gradually diminish-
ing the tension.

Some persons find that a brisk walk in the open
air for half an hour has the relaxing effect; but
to others this muscular exercise is irksome, and
consequently disturbing rather than helpful. A
very effective method, as innumerable persons
have discovered, is to indulge in some kind of light,
pleasant reading for an hour before bed-time.
Beading in itself is such a reflex act that it re-
quires very little mental effort ; while the interest
of the text, such as that of a story, relaxes the
mind without taxing it, and prepares it for sleep.

Some such expedient seems almost necessary
for those who spend most of their waking hours in
reading or writing; for to such persons the ab-
sence of the accustomed printed page before the
eyes does not check the activity of the mind.
When, however, the printed page is there, but its
contents of such nature that it requires practically
no cerebral effort to interpret it, a distinctly re-
laxed mental condition is produced. It is said
that the great German historian, Mommsen, whose
mind was wonderfully active and retentive, rested
his brain by devouring all manner of ' ' yellow-
backed " novels during his resting periods of the
day or evening. Thus an unusually receptive
mind, which retained desirable information with
remarkable" precision, was rested and recuperated
by the kind of careless novel reading that ordi-

124 Increasing Your Mental Efficiency

narily is so detrimental to the memory. But
Mommsen took his novels as medicine, so to speak,
not as real mental pabulum.

The method of preparing the mind for sleep by
reading or other diverting process, may be re-
garded as psychic rather than physical, although
it is probable that the ultimate effect of depleting
the brain of blood is the same by whatever process.
But there is at least one way of producing this
condition mechanically that is most effective and
often expedient. This is through the agency of a
prolonged tepid bath taken just before retiring.

In order that the bath may be effective, some
little care about certain details is necessary, since
carelessness in these matters may result in effects
exactly opposite to the one desired. Thus a bath
that is too hot, or too cold, or one that is taken
for a very brief period, may tend to constrict the
vessels of the skin, producing a cerebral conges-
tion rather than depletion. On the other hand if
the water in the tub is slightly warmer than the
natural heat of the body, which can be determined
by the hand without the aid of a thermometer, the
desired effect is readily produced.

The person taking such a bath should do so
just before getting into bed. He should lie in the
tub with the body completely submerged, with
a cool wet towel placed on the head, and remain
for fully fifteen minutes. He should then dry
himself quickly and get into bed at once.

Stabilizing the Faculties 125

In this way the blood is mechanically diverted
from the head to other parts of the body. The
prolonged bath distributes the blood all through
the body by relaxing the vessels in the trunk and
limbs, while the cool towel on the head helps to
constrict the cranial vessels, and thus aids actively
in the depleting process.

But of course it is not always convenient to
take a prolonged bath before retiring; and in any
event, if one were obliged to continue taking such
baths habitually to induce sleep, a truly bad
habit would be formed. As an occasional aid,
however, the prolonged bath is of greatest useful-
ness.

As a ready means of inducing sleep, one of the
various purely mental expedients is probably bet-
ter for those who are habitually prone to sleep-
lessness without definite physical cause. The
author of ' ' The Science of Happiness ' ' suggests
one of these methods that seems particularly com-
mendable.

" Challenge systematically any line of thought
that appears, and banish it from consciousness,"
he instructs. ' ' The thing is not difficult for a dis-
ciplined mind. You have simply to vow mentally
as you find yourself thinking on any subject, ' I
will not think about that,' and as it were you shut
off the current in that direction. Of course
through association your mind is instantly sup-
plied with some other line of thought; but this

126 Increasing Your Mental EfHciency

also you challenge in the same way as soon as it
appears, and so on as long as you are conscious.
You thus prevent any single line of thought from
becoming paramount in consciousness, and one
line after another being subordinated, the tendency
is to a lower and lower level of mental activity,
till presently consciousness is lost. It is possible
for some persons to put themselves to sleep vol-
untarily in this way at any time when they choose
even during the day and in the midst of most
active thinking. The boon which such an accom-
plishment furnishes the tired brain on occasion,
makes the acquisition of this power well worth
the effort."

It is probably superfluous here to call attention
to the necessity of thoroughly ventilating the
sleeping apartment during the night, as a knowl-
edge of the recuperative effects of fresh air has
become a part of our education. Yet experience
shows that, even to-day, there are many cases of
insomnia, or at least bad sleeping, due to neglect
of this fundamental principle of hygiene. The
sleeping-porch, and cool bedrooms with all win-
dows hoisted, will correct many cases of sleepless-
ness. Nothing supplants fresh air as a soporific.
And we may add that no room, even with many
windows, and all wide open, quite equals the open-
air bedroom. Any one who will make the experi-
ment even for a single night will be convinced
that there is a very distinct difference between the

Stabilizing the Faculties 127

night air in the open, and the air that circulates in
an open hedroom.

Most persons who make the experiment of sleep-
ing out of doors are loth to discontinue it. A few
nights of open-air sleeping make the bedroom
seem stuffy and intolerable. And herein lies the
one disadvantage of the sleeping-porch : if it can-
not be used habitually the discomforts of the in-
tervening nights spent indoors may offset the re-
freshing effects of the nights in the open.

Under favorable circumstances, then, the use of
the sleeping-porch is ideal. But if one is so sit-
uated that he must spend half his nights within
doors, it is probably better to substitute wide-open
windows, particularly if the individual is so sen-
sitive to atmospheric conditions that the nights
spent in the bedroom are likely to be restless ones.

We said a moment ago that insomnia was fre-
quently a most important danger signal fore-
shadowing possible mental unbalance. Concomi-
tant with this, and in many instances producing it,
is the tendency to worry — the basis of the great
majority of cases of mental breakdown, referred
to in a preceding chapter.

It would, of course, be impossible, except in a
most exhaustive treatise, to touch upon the multi-
farious forms and causes of the all-pervading and
most complicated mental condition indicated by
the single word ' ' worry. ' ' The life-quest of each
person is happiness, in the particular form which

128 Increasing Your Mental Efficiency

fulfils his conception of the term: the opposing
factor which prevents its consummation is worry,
in one or another of its varied forms. Obviously
then the term is too comprehensive for more than
general consideration. In one form or another
it touches upon every phase of human life.

When there is a definite cause for the mental agi-
tation the remedy is obvious, although frequently
difficult to apply. But sometimes an obscure
physical ailment that is not suspected, pro-
duces an apparently causeless kind of apprehen-
sive depression. This condition is so well known
— although less frequently understood — that it has
been a subject for facetious comment for genera-
tions. It was, indeed, the theme for the caption
of a humorous sketch in one of our " lighter
vein " weeklies a short time ago. Two intimate
acquaintances were pictured as meeting casually
on the street, one of them greatly agitated.

" Margaret," the agitated one exclaimed, "I'm
just worried to death about something."

" Why — er — why, for the life of me I can't re-
dear? " inquires Margaret.

" Why — er — why, for the life of me I can't re-
member."

Now the theme for this little pleasantry may be
found in innumerable eases, and its import is not
a matter for jesting. It is a kind of apparently
causeless worry that is most significant, and
should not be lightly disregarded. Whether the

Stabilizing the Faculties 129

person so afflicted can fathom the cause of the
anxiety or not, the cause actually exists, and
should be sought out and corrected. It represents
a state of abnormality in which the mental symp-
tom is likely to be caused by some definite physical
difficulty, usually the improper functioning of
some of the organs of the body. Our ancestors
placed the burden of responsibility upon the liver.
At present we are inclined to exonerate that organ
in most cases. But whatever the exact cause, the
person afflicted with this type of apparently cause-
less mental agitation — the feeling that " some-
thing dreadful is going to happen " — is approach-
ing a danger zone and should seek medical advice.

Sometimes this condition may be corrected by
proper mental training alone; for mental uplift
and fitness tend to induce physical fitness. And of
course it is part of the physician's art to com-
bine his psychotherapy with his more tangible rem-
edies. But, knowing as we now do, that there is
usually a definite physical basis for mental states,
one should not trust to psychic remedies alone until
it is clearly determined that the physical basis is
wanting, or unimportant.

Much more tangible physical causes for mental
aberration are the venereal diseases. And, despite
the fact that the prevention of this fertile cause
of insanity rests entirely with each individual,
save in a few exceptional instances, the number of
cases of aberration resulting from venereal dis-

130 Increasing Your Mental Efficiency

ease is conspicuously large. A single disease of
this category is responsible for at least twelve
per cent, of all cases of insanity to-day — seven
thousand deaths annually from its sequence,
paresis, in the United States. It is therefore of
greatest significance and of gravest importance.
But since this condition ■will be considered some-
what in detail in a later chapter, we need merely
touch upon it here to emphasize the dreadful na-
ture of the penalty which this most easily prevent-
able form of mental aberration exacts.

The special symptoms that we should regard
with suspicion when occurring in ourselves, or in
others, as pointing, or leading to, mental insta-
bility, may be summarized in a sentence : A tend-
ency to brooding, changeability, mental irrita-
bility, unusual susceptibility to mental fatigue,
headaches, suspiciousness, over-sensitiveness, —
any one of these, or combination of them, should
be regarded as warnings. To this list we may add,
an unusual sensibility to small quantities of alco-
hol, although this is an inherent defect, rather
than a symptom of progressive pathological con-
dition.

Normal Exhaustion and Abnormal Fatigue

Without examining them too categorically, let
us consider the exact implication of some of these
terms, such as mental fatigue. There is a great

Stabilizing the Faculties 131

difference between the normal exhaustion that fol-
lows prolonged mental effort, and the pathological
condition in which even a very small amount of
effort causes a feeling of fatigue. In the main
this effect must be gauged by each individual for
himself, measured by his own past experience. If
he finds that he is no longer able to sustain his
usual mental efforts — his normal standard, in
other words — he should at once seek the reason
for this change. But in seeking this reason, he
should not be misled by the common fallacy of
attributing this fatigue to an overworked brain.
For ' ' brain fag ' ' is usually merely a symptom of
some obscure physical depression.

Activity of mind does not tend to wear out the
brain, but quite the reverse. Indeed by constant
exercise the brain increases, rather than dimin-
ishes, its capacity for work. And this activity is
not maintained at the expense of bodily vigor, as
shown by the fact that men whose intellectual
pursuits require constant exercise of their brain
cells are usually long-lived. On the other hand,
mental lethargy, like sedentariness, foreshadows
early decadence, indicating that the brain, like the
body, is far less likely to wear out than to rust out.

It is obvious, therefore, that any person below
the age of actual senility, who finds that mental
exertion fatigues him to an unusual degree, should
take careful inventory of his condition. More than
likely he will discover that his body, rather than

132 Increasing Your Mental Efficiency

Ms brain, is at fault. In all probability he will be
able to locate the cause as his failure to give that
body the same healthy exercise that he has given
his mind. The remedy is obvious. A little active
muscular exercise, carried out systematically,
usually brings back the mental activity, frequently
with renewed and even increased vigor.

The question as to what sort of exercise should
be taken cannot be answered in a sentence ; for the
same prescription is not appropriate for all cases.
Age, environment, and previous habits must all be
considered in making the choice. Healthful exer-
cise for a man of thirty might be fatal to a man of
sixty; and environmental conditions are fre-
quently determinant factors. But, whatever the
form selected, it must be pursued regularly and
persistently. Spasmodic efforts are practically
valueless. And yet nothing is more diflScult for
most of us than to force ourselves to take regular
and persistent exercise.

Open-air exercises are, of course, infinitely bet-
ter than those taken indoors, largely for the rea-
son that such exercises afford greater pleasure
than most indoor " grinds." The effect of the
exhilarating open air itself must not be minimized ;
but the pleasure derived from taking any exercise
is even more important than atmospheric condi-
tions. Little benefit is gained from any muscular
exertion that becomes mere drudgery.

For the man past forty, probably golf offers

Stabilizing the Faculties 133

more practical advantages as an exercise than al-
most any other game — providing, of course, one
likes golf, or can learn to like it. Indeed, for the
man who has never taken to any form of violent
exercise during his younger life, there is really
little choice. Tennis is too strenuous; and base-
ball and football out of the question. Rowing
is a fine exercise, but requires special conditions,
and is not adapted to all seasons. Horseback rid-
ing fulfils all requirements, but cannot be indulged
by most persons, while stream-fishing and hunt-
ing, although excellent in themselves, can only be
pursued spasmodically, for obvious reasons.

The long-lost art of archery offers incomparable
advantages as an outdoor exercise — if one would
only practice it. It is a wonderful developer of
chest, back, and arm muscles, trains the eye, and
steadies the nerves. A lawn, some convenient
vacant lot, or even a porch, can be requisitioned for
a range, and all members of the family participate
in exhilarating contests. But, unfortunately,
archery is no longer fashionable. And where is
the person with the temerity to flout Dame Fash-
ion for mere health's sake?

One who has been accustomed to violent athletic
sports requires a somewhat different routine of
exercise later in life from the person who has
never been athletic. The athlete should, of course,
continue systematic and regular exercise through-
out life. But even if he has neglected his muscular

134 Increasing Your Mental Efficiency

system for several years, — between the age of
twenty-five and forty, let us say — and is still or-
ganically sound, he can quickly accustom his sys-
tem to even very violent exercise, such as wrest-
ling, without danger.

The person who has never done any violent ex-
ercises in early life, however, should be warned
against attempting them later. His heart and
blood-vessels have never been developed to full
capacity, or tested by violent exertions, as have
those of the young athlete; and it is dangerous
to make such a test after forty-five, unless under
the most careful supervision. Moreover, such an
undeveloped system does not require the same
sort of stimulation as that of the fully developed
athlete. It has so adjusted itself to this lack of
muscular development, that its standard of nor-
mality is greatly lowered ; and moderate exercise,
in a very restricted sense, is usually sufficient to
maintain a healthy muscular tone.

Such persons are often fond of walking; and
for them walking in the open air affords sufficient
exercise. But this moderate exertion does not
suffice, as a rule, for the former athlete, or the
person accustomed to the violent outdoor games
of youth. The muscular effort is so little more
than that of the ordinary daily routine, and is of
such similar nature mechanically, that it can
hardly be considered exercise in the therapeutic
sense. Moreover, unless one is fond of walking

Stabilizing the Faculties 135

he does not do it with zest, or get the exhilaration
produced by some of the more unusual forms of
exertion.

However, it is much better than nothing, and
unfortunately is frequently the only kind of exer-
cise available. And when it is combined with
systematic indoor gymnastics, it may serve to
complete an ideal combiuation.

At the present time there are at least a score
of books, or " systems," which may be had for a
few cents, that give instructions for courses of
simple exercises, which, if followed, will put the
system into good physical condition. Miiller's
My System, and Gulick's Ten Minutes Exercise
for Busy Men, are excellent. But no prescription
is useful unless filled. And most persons find
the regime prescribed in these " systems " so irk-
some, that despite their good intentions, very few
carry it out persistently.

It is perfectly certain, however, that fifteen
minutes of exercise daily, with or without any spe-
cial apparatus, will keep any person in good
physical condition. In proof of this, if proof were
needed, is the fact that gymnasts who do a daily
turn on the stage involving about fifteen minutes'
work each day, take no other exercise. And yet
nothing is more difficult for most persons than to
force themselves. to take those few helpful minutes
of systematic work each day. Many of my readers
can testify to the truth of this assertion, I feel

136 Increasing Your Mental Efficiency

sure. But when health is to be weighed in the
balance against ten or fifteen minutes of odd time,
there should be no hesitancy in making the selec-
tion, and pursuing that selection systematically.

At first this daily grind is most irksome, and re-
quires considerable urging of flagging will-power.
But as soon as the muscles begin to respond, and
become firm and elastic, as they do after a few
days, the task becomes less onerous ; and presently
it becomes a positive pleasure. The difficulty in
the undertaking lies in getting safely through
those first few days of halting muscles, and flag-
ging will.

One of the most destructive factors to mental
equilibrium and stability is the habit of har-
boring gloomy thoughts — in other words the
tendency toward pessimism instead of optimism.
It may be objected that some persons are " nat-
urally " pessimistic, while others inherit a happy
disposition. There is, of course, more than a
grain of truth in this : some individuals are more
fortunate than others in their natural endow-
ments. But we cannot emphasize the fact too
strongly that disposition is not an inherent qual-
ity which is irrevocably fixed by nature. A happy
disposition, or a gloomy one can be cultivated and
enhanced by persistent effort. Moreover, indivi-
dual dispositions are not determined by sur-
rounding conditions or circumstances, in most in-
stances.

Stabilizing the Faculties 137

We find a tendency to pessimism in persons who
have no extraneous reason for such an attitude of
mind rather more frequently than among those in
whom the feeling would seem justifiable. We may
be certain, therefore, that the development of this
mental attitude is the result of faulty training
quite as much as any inherent tendency. And
since the gloomy, brooding tendency is the dan-
gerous one, we should follow the dictates of the
philosophers of all time, and sedulousy avoid it.

" It is our own ills, not those of others which
we should treat with philosophical disdain," says
Dubois. And it is excellent advice.

In criticism of this philosophy it may be pointed
out that persons whose minds have become ac-
tually unbalanced do not reaUze their mental
abnormality — cannot appreciate that their atti-
tude of mind is perverted. The statement is, in-
deed, almost axiomatic. But this introspective
obtuseness is a later phase of the disorder. In the
early stages of mental aberration the afflicted per-
son usually realizes that something is wrong with
him, even though his most intimate friends may
not suspect it. Most normal or even semi-insane
persons appreciate their own shortcomings far
better than any one else; and if these shortcom-
ings are of a nature that tends toward harmful
peculiarities, or habits, it is the part of ordinary
wisdom to correct them before they become per-
manently fixed.

138 Increasing Your Mental Efficiency

We have said in another place that if the child
has received proper training in its early years
it will have developed a normal trend of mind that
will persist throughout life. It follows, therefore,
that most persons who become unbalanced have
not received such training, excluding, of course,
those cases of mental aberration caused by injury,
or organic diseases. The abnormalities exhibited
by the child are likely to develop in somewhat
similar form later in life, unless thoroughly sup-
pressed by training. This fact is helpful in in-
dicating the point from which danger may be ex-
pected, and thus suggest methods of avoiding it.
And these methods differ very little in principle
from those suggested for correcting abnormal
tendencies in children, although in the adults they
must usually be self-applied.

Frequently, of course, friends notice changes in
the personality of others before such changes are
fully appreciated or admitted by the individual.
In such cases it is the part of duty, and of wisdom,
frankly to point out the discovery and cooperate
in the process of correction. The fact that others
have discovered these changes, which the patient
may only vaguely appreciate, or may have
striven to conceal, helps him to overcome the
threatened affliction.

We must not confuse passing changes of mood
with those that are persistent and harmful. All
persons are subject to such changes, which are en-

Stabilizing the Faculties 139

tirely natural, normal, and, within reasonable
limits, helpful. The passionless, colorless life
that seldom fluctuates from a monotonously
level plane, is likely to be a very useless one.
But prolonged changes in disposition, without
adequate cause, should be regarded with suspi-
cion.

These changes tend to take one of two courses,
one toward unnatural excitement or exaltation,
the other toward depression and degradation,
more frequently the latter. Stated in another
way, the person with wavering mental balance is
far more likely to neglect the niceties of deport-
ment than to exalt them. We see examples of
these two conditions exhibited in the temporary
form of insanity caused by alcoholic excesses.
Some drunken men become ludicrously punctilious
in their deportment ; but far more frequently the
opposite extreme of carelessness in dress and de-
portment is exhibited. And a similar carelessness,
rather than punctiliousness, is characteristic of
most forms of mental aberration.

Any person who is subject to violent outbursts
of anger should labor ceaselessly until he over-
comes his affliction. For the tendency to indulge
in such outbreaks is likely to become progressively
worse if not curbed ; and these explosions are most
destructive to the mental structure. There is an
actual and rapid destruction of brain tissue during
such outbursts, and the more frequently they

140 Increasing Your Mental Efficiency

occur, the less time is given the system to repair
the physical change. The complete exhaustion
and collapse that follow such outbreaks is indica-
tive of brain-cell changes much more destructive
than many hours of intense, but controlled, mental
effort.

It is a matter of common observation that the
type of person who is naturally " quick tem-
pered, ' ' but who has learned to control his temper,
is likely to rise intellectually far above the level
of the passionless and placid individual. For
quick wits and quick tempers frequently go to-
gether; and the suppression of one tends to en-
hance the other.

The person who expends his energy in bursts of
anger depletes his mental magazine by an amount
exactly proportionate to the violence of his pas-
sion — harmful expenditure that might otherwise
have been diverted into useful mental processes.
With his temper under control, however, his full
quota of energy becomes available for concentra-
tion along helpful, rather than destructive, chan-
nels.

One of the best known examples of a hot-tem-
pered man who had learned to control his passion
is that of Washington — not the " sickly, cherry-
tree " Washington, but the man as he was. Dur-
ing his long career of protracted trials, and ex-
asperations, only on a few occasions did violent
anger get the mastery of that forceful personality

Stabilizing the Faculties 141

— just enough, to show that the fiery demon was
chained, not destroyed.

Probably the best way to conquer bursts of
anger is to review the actual effects of such out-
breaks in calmer moments. A little reflection will
show that anger puts one at a disadvantage, phys-
ically and mentally. Quick, straight thinking, is
one of the assets of ability : the man in a passion
may think quickly, but his judgment is proverbi-
ally bad. And so when pitted against a calm mind
of equal ability his disadvantage is obvious. The
force that should be directed to correct thinking
is consumed in the false thinking created by anger.
This fact alone — the fact that anger gives advan-
tage to the opponent — should offer sufficient stim-
ulus for conquering the tendency to violent out-
bursts.

The physical disadvantages of great anger are
just as demonstrable as the mental. It is one of
the fundamentals of boxing, for example, to keep
one's temper. " Get the other fellow mad " is
elemental in the boxer's training.

I recall an illustration of this principle during
the early training of a promising beginner with
the padded gloves. The young man, who had been
led to overrate his fistic ability by successful con-
tests with fellow amateurs, was taking his first
serious lesson from a master instructor. The fact
that the veteran eluded him at every turn at first
surprised, and then nettled him into obviously

142 Increasing Your Mental Efficiency

suppressed anger. At tMs stage, the instructor,'
who was studying his pupil's mood with thorough
understanding, began deftly tapping the young
man's face just hard enough to sting and irritate,
and with exasperating frequency.

Stung by the blows, and by the laughter of the
onlookers, the boy lost every vestige of self-con-
trol and rushed upon his tormentor to annihilate
him. But instead of accomplishing this, he now
received more frequent and more stinging blows,
despite his frantic efforts. Finally he stopped
from sheer exhaustion, sobbing with impotent
rage. When the boy had regained his breath, and
bis equanimity, the instructor went over to him,
patted him on the back, and gave him some good
advice — excellent advice for every person, regard-
less of the source.

' ' Never get mad, my boy, ' ' he said. ' ' No mat-
ter what happens, smile. If the other fellow
nearly knocks your head off, just grin at him —
but don't get mad. For if you do, you can't think,
and then he'll hit you hard and often. But if you
just smile he'll think that he didn't hurt you, and
it will shake his confidence in himself. Pretty
soon perhaps he'll get mad — and then you'll beat
him."

This is the accepted philosophy of the ring —
accepted because it works. But it is just as ap-
plicable as a guiding philosophy in the higher
callings which require better, although no more

Stabilizing the Faculties 143

intense, mental efforts. For any intense excite-
ment such as violent anger, whicli throws a per-
son into a state of temporary confusion, may be
the portal to a permanent condition of mental
instability.

A certain degree of sensitiveness and a reason-
able amount of suspicion govern the deportment
of every normal person. Moreover, the limits of
these normal variations are elastic, and differ in
each individual. Every self-respecting person
must be sensitive in some degree; and even ordi-
nary business ventures require that a certain
amount of the kind of suspicion which is engen-
dered by caution, must be exercised.

But hypersensitiveness, which is frequently ac-
companied by an excessive amount of baseless
suspicion, denotes bad mental balance. We must
always be questioning the motive of others to a
certain extent — it is the basis of all our business
transactions, and studies of human nature. But
a strong tendency to read evil motives between the
lines is a paranoid one that leads away from the
paths of normal optimism.

The person who is forever on the lookout for
fancied slights will usually find them, and be
caused much unnecessary unhappiness by a thou-
sand and one meaningless incidents. So long as
the mind of such a person is open to reason, how-
ever — so long as a plausible explanation convinces
him of his error, his attitude of mind, while un-

144 Increasing Your Mental EfHciency

fortunate, eaanot be considered abnormal. But if
constant suspicions drive him to a point where
reasonable explanation does not convince, a point
at which he reasons from false premises, he has
reached a state of mind that is crowding the inner
border of the danger zone.

Such a person must take himself firmly in hand,
cultivate the habits of overlooking trifles, and re-
gard the generalities of everyday life from an
optimistic point of view. He may, to advantage,
adopt and amplify the rules once given me by a
village carpenter, whose mind evolved a helpful
philosophy, while his body pursued its more
plebeian tasks. His philosophy may be summar-
ized thus : If your friend fails to notice you in the
passing crowd, very well : there are other friends
— plenty of them. Or, more likely, he did not see
you. If you are sensitive, and suspect that people
are talking about you, What of it? They are talk-
ing about their betters, and can be ignored. Thus
putting aside each obtruding disagreeable impres-
sion and substituting an optimistic one, you stifle
the paranoid tendency, by a healthful process of
introspection and self -education.

" This work of self -education is less difficult
than one would think, ' ' says Dubois. * ' I see every
day sick people who during all their lives have
suffered cruelly from this impressionability which
renders them incapable of performing their duties.
Often in some days, almost always in some weeks

Stabilizing the Faculties 145

they succeed in altering their point of view, in see-
ing things from another angle. In proportion as
they recover their mental calm under the empire
of healthy reflections, functional troubles disap-
pear, sleep returns, and appetite arises, the body
becomes stronger, and the success of this mental
treatment demonstrates the supremacy of the
mind over the body."

It is helpful and gratifying in reviewing our
own shortcomings, to reflect that even the wisest
man is utterly incapable of fathoming the motives
of others in a vast majority of instances. It fol-
lows, therefore, that it is folly to waste one's time
on so futile a task ; and it is positively harmful if
the motive is engendered by brooding suspicions.

I knew a man — a man who was an exceptionally
good judge of human nature — who made the fol-
lowing experiment to determine just how accu-
rately he could interpret the motives for certain
actions in others : Each day he took note of inci-
dents that came to his attention among his friends
and acquaintances, studying them carefully until
he had reached a conclusion as to the motive, and
then writing down his interpretation. When he
had accumulated a long list in this manner he went
to each individual, explained what he had been
doing, and asked each one to affirm or deny
whether his interpretation was correct. In not
one instance was his interpretation entirely cor-
rect, and in most instances it was utterly wrong !

146 Increasing Your Mental Efficiency

His culminating experiment gives a general
idea of the methods pursued. An editor had re-
cently returned him a manuscript with the usual
polite editorial form that " it was not available
for our publication." The experimenter had
formulated three reasons for its refusal : (1) it was
not written well enough; (2) the subject was not
interesting; (3) it was either too long or too short.
These he submitted to the editor, who promptly
gave him a fourth (the real reason) by show-
ing the author a manuscript dealing with the same
subject as his own, written and accepted some
time before.

Closely allied to the suspicious, paranoid atti-
tude of mind is one of excessive and unreasonable
jealousy. Frequently the two are concomitant.
The difficulty here, just as in the case of suspi-
ciousness, is to draw the line that exactly marks
the division between normal and abnormal jeal-
ousy. But when any one is obsessed by unre-
strained doubts his judgment becomes very
quickly impervious to evidence, and the line shifts
towards abnormality. The inevitable result is
unhappiness: the possible result, disturbed
mental equilibrium, unless the tendency is cor-
rected.

" The cultivation of a thankful spirit and a
reasonable humility," says Hollander, " and the
determination not to let the pin-pricks of life up-
set them, would do much to prevent men and

Stabilizing the Faculties 147

women getting on the slide whicli ultimately leads
to the quick descent into unsoundness of mind."

One cannot emphasize too forcibly the effects
of these " pin-pricks," both in the giving and the
receiving. They are the basis of more mental
distress and unsoundness than all the cataclysms.
The household that is cursed with a nagging mem-
ber is far more liable to disruption than one in
which a member is subject to fits of temper.

The term ' ' nagging ' ' needs fuller explication.
There are all gradations in kinds and degree, from
the vituperating " scolds " of ducking-stool no-
toriety, to the quiet, insidious, insinuating pin-
prick type. The fault-finding scold is the more
detestable; but undoubtedly the quietly obtrusive
type is the more dangerous one, judged by ultimate
results. The explanation of this has a sound
physiological basis. The person who is subjected
to periodic beratings with intervening periods of
calm, is given opportunity for mental recuperation
between castigations. But the mind that is sub-
jected to continual nagging, fault-finding, and
criticism, is placed in a state of continuous appre-
hension — a condition of high mental tension in
which there are no resting periods for recupera-
tive repair.

Few persons, aside from the physicians familiar
with the causes of mental unsoundness, appreciate
the amount of actual insanity, and the number of
premature deaths from organic diseases, produced

148 Increasing Your Mental Efficiency

by the quiet, smoothtongued type of " naggers."
Yet their peculiar capacity for creating evil may
be little suspected except by their immediate
friends. For this particular type of person is
found most frequently among the cultured classes
in the upper walk of life, whose esthetic training
causes them to repress their feelings in public bet-
ter than those in less exalted social positions.

Every veteran physician, did he choose, could
cite specific cases in his community in which the
nervous systems of entire families had been de-
moralized by one nagging member. And fre-
quently this particular person is the one that would
be least suspected by an outsider. Let me cite
one typical case that was the subject of personal
observation for several years.

The woman who was responsible for this par-
ticular tragedy was bom of wealthy parents, given
the kind of education fashionable among the
" aristocracy " of our grandfathers' time, and
launched upon life mated to a man who was her
equal in culture, her superior in intellect. His
only inferiority was in the matter of worldly
goods — a thing that, looked at in retrospect,
played an important part in the ultimate catas-
trophe.

This woman had one quality of mind that is
seen so frequently iu the highly cultured mem-
bers of " old families," namely, obstinacy — a
thing by no means synonymous with firmness.

Stabilizing the Faculties 149

And the manner in whicli this peculiar type of
obstinacy manifested itself was in a not unusual
trait of making every one do things her way, not
their own. But this somewhat characteristic fem-
inine quality obtruded itself into every depart-
ment of her family life, even dominating the
amusements of her two sons in a peculiar manner.
Her attitude of mind may be summarized as wish-
ing her children to enjoy themselves, but only
in the manner which she prescribed, or in the
amusements she selected.

While the children were young this attitude was
entirely commendable, as her selections were
usually good. But as the boys grew older they,
very naturally, wished to be their own choosers of
amusements and companions. They were, in
short, approaching a state of manhood, with the
tastes peculiar to men, and beyond the under-
standing even of a mother.

Yet the mother's peculiar obsession did not
change. Whatever the boys proposed doing, and
wished to do, was always rejected, and some sub-
stitute offered. If they selected skating, she sug-
gested coasting; if they chose the theatre, she
advised a concert; if they had planned a duck-
shooting excursion on the river, she insisted on a
quail hunt. And, what is more significant, she inva-
riably carried her point. So that although the boys
were given all manner of amusement and enter-
tainment, they were in reality never doing what

ISO Increasing Your Mental Efficiency

they really wanted to do most. They suffered
from " over protection " of a peculiar kind; or,
stated in another way, were " tied to an elastic
apron string," — elastic, but with tension that
never completely relaxed.

Had these boys been of the deceitful type, who
would pretend to go quail hunting but in reality
be shooting ducks, as they preferred, I believe they
would have profited in mental stability, despite the
deception. Yet had they rebelled, and insisted on
their own form of amusements, they would have
been confronted with a subtle obstinacy which of-
fered no loop-hole to direct attack. They had no
choice but to take the form of amusement that
their mother decided they should enjoy, — and so
half enjoy themselves. The result was the crea-
tion of an attitude of mind in which the essential
element of complete gratification was wanting.

The fact that the mother's method was one of
quiet, insinuative persistency, explains its effi-
ciency. Open opposition on her part would have
produced open rebellion in the boys, who were
sturdy, manly fellows. But hers was the more
subtle, effective method of seemingly gently lead-
ing, which was in effect obstinate driving.

The mother's peculiar attitude did not change,
even after the older boy had grown to manhood,
and graduated from college. Indeed her peculiar-
ity had rather increased, as is usual with any
eccentricity that is nurtured by persistent exer-

Stabilizing the Faculties 151

cise. She still continued to select, or oppose, the
companions, amusements, and occupations for her
son, just as she had been doing for years.

The result was inevitable. Inheriting from his
naother her temperamental peculiarities which
were aggravated by her attitude, the mind of the
older boy gave way, and he became hopelessly in-
sane. Hard study caused the catastrophe, the
friends said. It had nothing to do with it. Per-
sistent, insinuative, insidious nagging (I know of
no better term) was the exciting, and determina-
tive cause.

A brief summary of the later phases of this
tragedy is illuminative. The unfortunate young
man was placed in the care of the greatest physi-
cians of Europe and America successively. But
for several years his condition made confinement
in an asylum necessary. Then, as his mind had
become more enfeebled, and his attitude less
aggressive, he was allowed to travel about accom-
panied by companions and physician. Meanwhile
he had developed a peculiar " negatism " similar
to that of his mother, — an obstinate persistency in
refusing to do things that others suggested, even
when he really wished to do them.

Moreover, like many cases of alienation, he had
taken a decided aversion to the members of his
family. This attitude was particularly apparent
when his mother visited him. During those visits,
which were made at intervals of several months,

152 Increasing Your Mental Efficiency

the son became progressively more unhappy, dis-
turbed, and confused, as a result of the active
stimulus to his repressed emotions.

For the passing years, and accompanying sor-
row, had wrought no change in the mother's atti-
tude, or activity in selecting recreations for her
son; and meanwhile, as we have seen, the son
had developed a similar active negatism of his
own. Thus their points of agreement were quite
as far apart as ever. The mother's carefully laid
plans for her son's recreations (and she was for-
ever making them) were always promptly re-
jected, and a substitute suggested; while the son's
plans met the inevitable rejection, or substitution.
Or if, by chance, both hit upon the same plan at
the same time neither could resist the opportunity
to switch to some other.

Even in these peculiar circumstances things
would have run along fairly well had the mother
been willing to exercise a reasonable flexibility
of mind. But she would not — probably could not,
at least in later years. One does not change one's
mental attitude at three score and ten. And so
the distressing drama was enacted day after day
during her periodic visits.

You will say at once that this woman was ab-
normal, — quite as insane as her son. Had you
known her, however, even as an intimate acquaint-
ance without the knowledge of her immediate
family, you would probably be inclined to change

Stabilizing the Faculties 153

your opinion. A brilliant, active mind, a tireless
reader and intelligent interpreter of good litera-
ture, a charming hostess, and a matchless house-
keeper — where would you find ground by ordi-
nary standards of observation for your diagnosis?

And yet you are not far wrong. Her natural
mother's love, which she believed governed her
every action, was really dominated by an intense
selfishness which had become a form of mania.
This selfishness constantly perverted, and in ef-
fect, replaced the natural affection.

There is a valuable lesson that may be learned
from this strange, although in its essentials, char-
acteristic example, and one that every person who
is given to chronic mental antagonism, or kindred
attitudes, should heed. For "nagging" is not
merely a disagreeable habit, but a manifestation
of that most despicable human trait, selfishness.
Moreover, its effects are much the same whether
it be exhibited in perverse actions, couched in the
strident voice of the termagant, or spoken with
the carefully modulated intonation of cultured re-
finement. Like continual bursts of anger it is
progressively destructive of the nervous system.
But its effects are somewhat different from those
of bursts of temper in being less self -destructive,
but more harmful to the nervous system of others.

The popular metaphor, comparing the unfor-
tunate lunatic to a " cracked pot," is an ancient
one. Its exact origin is uncertain. But if we carry

154 Increasing Your Mental Efficiency

the comparison between mental misfortunes and
broken cbinaware one step farther, we can see
how this crude comparison may have originated.

Every one knows that cracks in earthenware
cannot be completely concealed or repaired. But
there is another condition which, in its ultimate
effects is just as destructive to the piece of ware
as the more palpable cracks. This is the minute
system of cracklets that occur in the over-glaze
of a piece in which this glaze is not properly
adapted to the body of the ware. At first these
minute and apparently harmless cracklets are in-
conspicuous, although they may be discovered by
close inspection. But presently they become ob-
trusive, covering the ware with a fine network of
discolored lines — a condition seen in old pieces of
badly made china. When this stage is reached
the substance of the ware is beginning to disinte-
grate, little as one might suspect it. It has lost
its ringing tone, and presently it falls to pieces —
destroyed much more completely beyond repair
by this network of cracklets than by any single
gaping fissure.

The difference between these two conditions is,
that although the actual fissure can never be re-
paired so as to conceal the crack even when use-
fulness is restored, the little cracklets may be re-
paired by a proper system of appropriate glazing,
and the piece made as good as new in every par-
ticular — provided, always, that this re-glazing is

Stabilizing the Faculties 155

done before the underlying body-structure is
affected.

Curiously enough the name that potters give
this fine cracking of the glaze, is " crazing."

In the human piece of china, analogous condi-
tions present themselves. The conspicuous and
irreparable fissures that occur, represent the
cataclysms caused by injury and specific disease,
which produce incurable mental aberrations. The
little cracklets are the eccentricities, obsessions,
worries, and maladjustments to surroundings —
just as the minute fissures in the china are the
maladjustment of the glaze to the body-ware —
which, if not corrected in the beginning, eventually
lead to complete disintegration.

" Nearly all the world is cracked," says one
writer, " but some succeed in covering up the
cracks better than others. ' ' If actual cracks exist,
however, it will not be possible to conceal them
for any very great length of time. And if they
are simply little " crazings " — minute cracklets in
the mental over-glaze — it is far better to repair
them than to attempt the impossible task of con-
cealing, or rendering them innocuous.

VI

The Problem of Ancestry and Environment

" rpHE human race to-day is the expressed sum
-■■ of all the good, bad, and indifferent that
have existed in the world from the beginning,"
says a modern philosopher. Or, stated otherwise,
each individual is a composite picture of all his
ancestors.

No one has ever seriously doubted the com-
ponent elements of the picture ; the only difference
in opinion has been concerning the perspective,
and the arrangement of the figures. Some have
been inclined to give undue prominence to remote
ancestors in the composition, while others have
practically ignored them, placing the figures of
recent ancestors conspicuously in the foreground.
Still others have brought environmental condi-
tions to the front, thus concealing the remote an-
cestors completely and crowding back the more
recent. In short there have been no fixed rules
for composing the picture, at least until the clos-
ing' years of the nineteenth century.

To be sure Sir Francis Galton had formulated
his laws of heredity some little time before this.

IS6

The Problem of Ancestry and Environment 157

And Galton's empirical rules have proved to be
fairly accurate. But it remained for an Austrian
monk, Gregor Mendel, to fathom the riddle of
heredity, and formulate accurate laws whose truth
could be demonstrated by practical application.

Mendel's experiments were not made with
human beings, not even with the lower animals,
but were largely concerned with the little plant
familiarly known as the garden pea. What pos-
sible relation, you may well ask, have the laws
governing the heredity of a little plant to those
of the supreme animal, Man? or, for that matter,
to the lowest member of the animal kingdom?
The answer is simple and precise: they have
everything to do with it. The same fundamental
laws of heredity that govern the garden pea apply
to all other plants, and all members of the animal
kingdom, including man himself.

At the present time the knowledge of these laws
is being utilized in the practical development of
better plants and better animals. Eventually, we
may feel sure, they will be the means of produc-
ing a race of better men. The popular eugenics
movement of the present time is an earnest of this.
For bad heredity plays a leading role in a vast
majority of nervous disorders, particularly in
cases of mental instability; and the science of
eugenics, and the application of mental hygiene,
may insure future generations a better heritage
than our own.

158 Increasing Your Mental Efficiency

Some of the miraculous transformations that
have been wrought in plants, particularly the pro-
duction of disease-resisting species, suggest the
probability that similar effects will be produced
eventually in human beings, since the Mendelian
laws govern the heredity and methods of propaga-
tion in both. An interesting instance of the appli-
cation of these laws is the production of a rust-
resisting strain of wheat created by Professor
Biffin, which seems destined to restore the almost
obsolete wheat-raising industry of Great Britain.

A few years ago the ravages of the rust-fungus
had practically destroyed wheat-growing as an in-
dustry in the British Isles. Microscopic studies of
this fungus revealed the fact that in order to com-
plete the cycle of its existence it must live for a
time in barberry bushes ; and these bushes are used
extensively in Great Britain for hedges. By de-
stroying the barberry bushes the rust-fungus
would be exterminated. But such a radical cure
seemed almost as bad as the malady itself.

Professor Biffin found a substitute for this
wholesale destruction of the hedges. By breed-
ing experiments, based on Mendelian laws of
heredity, he produced a strain of wheat which re-
sembled ordinary English wheat in its quality as
a foodstuff, but differed in the important par-
ticular that it resisted the attacks of the rust-
fungus. Thus the scholarly old Austrian monk,
pottering with the pea-vines of his little garden

The Problem of Ancestry and Environment 159

half a century before, made it possible for the
modern English, agriculturist to raise his wheat
and keep his hedges.

This is but one example in a thousand that might
be cited as showing the practical value of know-
ing the laws of heredity. The California wizard,
Mr. Luther Burbank, has created hundreds of new
varities, and modified thousands, by his wonderful
application of these laws.

But obviously the application of Mendelian laws
for the creation of new species of plants, which
have neither muscular nor nervous systems, is a
much simpler process than its application to the
complex organisms of animals. Yet even in the
animal kingdom these difficulties are not insuper-
able ; and although the laws of heredity are more
difficult to interpret in the higher organisms,
enough has been accomplished already to show
that these laws apply with the same fixity here
as in the less complex ones.

Thus it is possible to produce predetermined
changes in color and anatomical peculiarities, with
almost mathematical accuracy in the offspring of
certain domestic animals and birds. Further-
more, the mental characteristics of such offspring
may be changed along definite lines under the
magic touch of the Mendelian experimenter.

It is one thing, of course, to predetermine that
a certain egg in a nest will produce a thin, active,
laying hen, its nest-mate a fat, stupid sterile fowl

i6o Increasing Your Mental Efficiency

for market purposes, and quite another to produce
at will a criminal or a philosopher. But if we
could control the ancestry of the criminal or the
philosopher, as we can those of the fowl; and
control, also, the additional item of environment,
which enters so largely into the problem of
eugenics, we should undoubtedly be able to pro-
duce results quite as definite in human beings as
in the lower animals.

In a way our civilization is doing this very
thing at the present time, and has been doing it
for ages — doing it badly when it produced a crim-
inal, and doing it well when a philosopher was
created. But, in either case, the individual was
simply a happy or unfortunate result of hap-
hazard natural selection. Had these selections
been governed by the standards of modern
eugenics during all past ages we should to-day
have more philosophers and fewer criminals and
degenerates.

One of the greatest difficulties in making com-
parisons between the effects of heredity in man
and the lower animals or plants, is the great dif-
ference in the time-element of generations in-
volved. The cycle of development in the lower
order of animals may be completed in months, or
even weeks, whereas in man the cycle is reckoned
in years. For this reason the student of human
heredity must make his deductions from, and base
his applications largely upon past records. But

The Problem of Ancestry and Environment i6i

even with this handicap he has been able to pro-
duce some very definite working data — enough, at
least, to demonstrate the soundness of his theories.

The evidences of heredity on normal anatomi-
cal structures are too patent to admit of argu-
ment. The commonplace example of a child's
resemblance to its parent is sufficiently demon-
strative. But we are more particularly concerned
here with the influence of heredity on mental
traits, especially those that have a pronounced
effect on mental unsoundness. And curiously
enough, it is through our studies of the hereditary
element in mental and physical abnormahties that
we are able to reach definite conclusions governing
the development of normal minds and bodies.

We have learned, for example, that near-sight-
edness (myopia) is frequently an inherited defect.
And this knowledge is most useful in studying the
children of a myopic parent. We have learned,
also, that the peculiar defect known as color-
blindness is inherited from the male, but trans-
mitted through the females of the strain. Thus
a color-blind father rarely has color-blind chil-
dren. But some of his nephews may be color-
blind ; and if his daughters bear him male grand-
children, we can predict with relative certainty
that some of them will inherit the defect.

It has been definitely determined that the color
in the eye is transmitted with the same exactness,
and according to the same fixed laws that govern

1 62 Increasing Your Mental Efficiency

the transmission of color to the flowers of the pea,
or the coat of the guinea pig. Thus, if both par-
ents have blue eyes, every one of their children
will be blue-eyed — a useful piece of knowledge
in certain legal complications. And whatever the
color, if the ancestry of the parents is known, we
can predict with great precision what the color of
the children's eyes will be.

It is evident, therefore, that certain abnormali-
ties of the eyes, as well as normal peculiarities, are
governed by the laws of heredity about which we
have some very precise knowledge. And we are
certain that the other anatomical structures are
subject to these same laws, even though we are un-
able to demonstrate the fact with the same pre-
cision as in the organs of sight. Moreover, since
mental traits are simply manifestations of definite
physical conditions, it follows that these traits
must be determined primarily by the same laws of
heredity as those governing physical conditions.
In short that the Mendelian laws apply to plants,
animals, human anatomy, and mental character-
istics.

We must remember, of course, that mental
traits are subject to the influence of environment
(training) to a far greater degree than are
anatomical structures. The preponderance of evi-
dence seems to show that all such traits, whether
inherited or acquired, are likely to be transmitted
to the offspring, particularly those acquired traits

The Problem of Ancestry and Environment 163

(or the tendency toward them) that concern the
higher intellect.

Galton, who inaugurated and named the modem
science of eugenics, believed that an individual
inherited from his parents one-half his traits ; one-
fourth from his grandparents; one-eighth from
great-grandparents, and so on. Many recent
observers are inclined to credit the parents with
rather more influence, and the more remote an-
cestors with less, than did Galton. The difference
at most, is one of small fractions. But the signifi-
cance of each of these estimates is the burden of
responsibility for the future of the child that it
places upon the parents — the only individuals in
the line of descent over whom we may hope to
have any direct control.

What we are chiefly concerned with here is the
extent to which mental defects, or the tendency
toward such defects, are transmitted, and to just
what extent they may be corrected by training and
environment.

The task of determining the effects of heredity
becomes increasingly difficult as we ascend the
scale of intelligence. We can, to be sure, point to
successive generations of persons possessing un-
usual mental endowment — the Darwins, the Her-
schels, and the descendants of Jonathan Edwards
— and no one will seriously question the important
part that heredity has played in determining the
superior intellects of these groups. But the in-

164 Increasing Your Mental EfEciency

fluence of heredity is shown even more exactly in
persons at the other extreme of the mental scale.
In other words, it is far easier to predetermine
mental incapacity, than to predict the limit of
mental capacity, from the known ancestry.

We cannot predict with certainty that the chil-
dren of two parents of unusual mental capacities
will rise to the supreme height of genius ; but we
are absolutely certain that all the children of two
imbecile parents will be feeble-minded without ex-
ception. And we know also that no child of un-
usual mental endowment will be born to parents,
either one of whom is below the normal standard
of intellect.

We know that the children of two epileptic par-
ents will all be defectives, — many of them epilep-
tics, and some of them imbeciles. The results of
three such matings have been recently recorded by
Dr. D. F. Weeks, as follows : " In three matings
both of the parents were epileptics. Of the 28
conceptions, 2 were still-births, 3 miscarriages, 3
died before two years of age, and one (an infant)
is too young for classification, leaving 19 about
whom something definite is known. Of these,
8 were epileptic, 3 feeble-minded, and 8, who
came from parents who developed epilepsy late in
life, were tainted." By " tainted," it should be
understood, is meant persons of unstable equilib-
rium, who are prone to lapse into mental unsound-
ness.

The Problem of Ancestry and Environment 165

Another group observed by Dr. Weeks offers the
following appalling record : " In 9 fraternities in
which both parents were feeble-minded, there
were 56 conceptions. Of these, 4 died before 2
years of age, and 14 were too young for classifica-
tion. Of the other 38 ." . .7 were epileptic, 29
feeble-minded, and 2 were drunkards, who may or
may not have been feeble-minded."

We see from these records that the mental de-
fects represented in imbecility, epilepsy, alid in-
sanity, are so closely related that they may be
transmitted interchangeably, so to speak. All of
them seem to represent negative qualities — actual
omissions of a positive element in the physical
make-up that is present in normal individuals.
And since a thing that does not exist obviously
cannot be transmitted, we find an explanation of
why imbecile parents, each of whom lacks certain
essentials to normal mentality, beget imbecile chil-
dren with deadly certainty. We find here, also,
the scientific explanation of why it is not advis-
able for near relatives, such as first cousins, to
marry, since both may have inherited similar
negative qualities, thus doubling the chances of
transmitting defects to their children.

Recent investigations of the ancestry and de-
scendants of persons of unstable mental balance,
enable us to make certain definite predictions.
We know, for example, that two normal persons
with normal ancestry will beget only normal chil-

1 66 Increasing Your Mental Efficiency

dren. But the case becomes complicated with' the
introduction of a single element of marked mental
instability.

Thus if a man who has been insane marries
a woman of normal mentality with pure normal
ancestry, all their children will probably be nor-
mal. But some of their grand-children are almost
certain to be defective.

If one of the parents have been insane, and
the other normal but inheriting a neuropathic
make-up even from one grand-parent, half of the
children will show mental or nervous instability,
and all will be capable of transmitting such in-
stability to their children.

If both parents are mentally unstable all their
children will inherit a tendency to mental in-
stability.

To summarize these conclusions, it appears that
any person whose parents are both abnormal has
considerably less than an even fighting chance
of keeping normal under ordinary circumstances,
although his case is by no means hopeless. On the
other hand, the individual with one defective par-
ent has considerably better than an even chance
under ordinary circumstances; and with proper
environment and training will in all probability
remain normal throughout life.

It is obviously of greatest importance, there-
fore, (1), to protect future generations by some
method of regulating or preventing marriage.

The Problem of Ancestry and Environment 167

among the unfit; and (2), to follow some system
of psychic training for those members of the pres-
ent generation of children with neuropathic taint
so as to fortify them against mental unbalance.
For that character of the child's mind which we
designate " stability," may be greatly increased
by environment, even when handicapped by bad
hereditary defects.

The child that inherits a stable mental equilib-
rium needs no special training to maintain its
poise. It is doubtful, indeed, if anything short of
actual physical injury to the brain, either by
traumatism or specific disease, will ever produce
aberration in such an individual. But needless
to say the number of children who come into the
world with such an enviable heritage, is limited;
and, on account of the complexity of our ancestry,
it is usually impossible to determine just how
preponderant the dominant traits in any particu-
lar individual may be.

On the other hand, no children, short of those
actually congenitally defective, are born with such
a bad hereditary taint that they are hopelessly
predestined to become insane. But it is obvious
that children with bad heredity require far more
careful training than those whose heredity is
good.

" Mental training " should not be confused
with education in the generally accepted sense.
For in some instances the ordinary forms of

i68 Increasing Your Mental Efficiency

didactic education are detrimental, and may very
advantageously be restricted rather than ex-
panded. Manual training, followed by some
humble vocation, is sometimes far better for a
nervous, sensitive child, of restricted mental
capacity, than the kind of education given in our
schools.

In any event we must distinguish between mere
learning and inherent mental capacity. One per-
son may have great mental capacity and little
learning, while another may have considerable
learning without very great mental capacity. It
is quite possible to increase our knowledge, but
mental caliber is an inheritance that cannot be
increased by training. Moreover, mental ca-
pacity, in most instances, has little to do with
mental equilibrium. In effect they are separate
organisms. But the man of great mental capacity
is far more capable of correcting the " wobbling
of his mental balance wheel " than the man who
is poorly endowed, because his introspective judg-
ment is more highly developed.

As referred to a moment ago, an exact knowl-
edge of certain phases of heredity enables us to
predetermine what the limits of mental capacity
in the child of imbecile parents will be, and also
the limits of mental capacity in children whose
parents are of mediocre mentality. This knowl-
edge may be of great practical value, since many
of the children from this mediocre stock are

The Problem of Ancestry and Environment 169

precocious in their early years, thus giving prom-
ises that they will never fulfil. In such cases an
early appreciation of the child's limitations may
be the means of making a useful, instead of a use-
less, adult.

Many of us will recognize instances of natural
limitations, if we compare the ultimate attain-
ments of our schoolmates with the promise of
their early school years. In the primary grades
of school the brightest and most promising pupils
frequently come from the most humble walks of
life — the children of the village cobbler, tinker, or
day-laborer, who have neither good heredity nor
inspiring environment. Apparently these chil-
dren defy our laws of heredity. But if we observe
them in their later years we usually find a strik-
ing confirmation of those laws. For most of them
drop into stations of life scarcely above the level
of those held by their parents. And in the case of
the exceptions — or rather, apparent exceptions —
we shall usually find that, despite their humble
social position, one or the other parent (usually
the mother, it appears) had ancestors of more
than ordinary mental capacity.

I recall a typical case among my own boyhood
acquaintance, the son of a cooper whose wife was
the type of ordinary domestic. This boy entered
the primary class in the village public school when
five years old, a bright, fine-looking little fellow, a
favorite with his mates and the leader in his

170 Increasing Your Mental Efficiency

classes. As social lines among the children were
not closely drawn, this little boy had the same
advantages as the more favored scholars, going to
parties and participating in all manner of child-
ish festivities. So that, aside from his actual
home surroundings, he had all the advantages of
the children of better parentage.

Moreover, since his parents were fairly well to
do, and greatly interested in educating their son,
there was no apparent reason why this boy should
not acquire a good education, and become a lead-
ing citizen in his community. But in his four-
teenth year he stopped going to school for no good
reason (he offered as an excuse that " he didn't
like the new teacher "), loafed about as an idle
boy for a year or two, finally drifting away from
his classmates. Eventually he married a girl in
his own station of life; and is now the village
cooper, occupying about the same social position
as that of his parents before him.

Those of village bringing up will recognize this
type of boy. He exists in every American com-
munity; and he exemplifies the limitations of in-
herent mental capacity. Leaving school at an
early age was significant. For he really did not
dislike his teacher more than the other boys in
his class — no more, indeed, than seems to be the
normal amount for a healthy boy of fourteen.
But he lacked that indefinable mental quality that

The Problem of Ancestry and Environment 171

the " winner " possesses — a quality that is in-
herent, not acquired.

Judged by the success of his early school years,
this boy inherited a highly organized brain. But
his later actions refute this assumption. The
quality he inherited was that of a rapidly develop-
ing brain, which quickly reached its limits of
capacity.

" Even if all education, including that of the
universities, were made free," says Hollander,
" there would always be some whose organiza-
tions, even after all educational efforts have been
tried, would fit them only for the position of
a shoeblack or a kitchen maid."

Yet as a young child, as we have seen, this same
shoeblack may have shown great precocity of in-
tellect — is quite likely to do so, in fact. For the
less highly organized type of brain, like the brain
of the lower animal, often develops more quickly
than the highly organized one, or may do so con-
spicuously in certain instances. Thus we find our
cobbler's boy the brightest pupil at six, and a dul-
lard at thirty; while an Oliver Goldsmith, appar-
ently a dullard at ten, is a genius at forty.

It is not always so, but the higher organisms
usually require more time for development; and
if quickly developed by forcing, are often poorly
balanced. The penalty of culture and refinement
seems to be the creation of a tendency to nervous
and mental instability. But perhaps this is only

172 Increasing Your Mental Efficiency

another way of saying that complicated machines
are likely to be delicate ones. Yet in the case of
the mental mechanism it is possible to correct
most maladjustments by proper training. And
once this training is completed, the resulting
mechanism tends to maintain its equilibrium quite
as firmly as those less complicated.

There are, of course, many manifestations of
the laws of heredity which as yet are not under-
stood, and which we have therefore no means of
correcting. Thus we know that fecundity and
fertility are physiological qualities that may be
inherited; and that these tendencies tend to de-
cline in the higher walks of life. We do not know
the explanation of this class favoritism of Nature ;
simply the fact. Since women in the upper circles
of life are not so well fitted physiologically for
bearing children, as a rule, as those in the lower
walks, Nature may be thus removing the burden
from the unfit. If so, we have a striking example
of the antagonism between the workings of
natural phenomena and those of our artificial
civilization; for economically, if not physiologic-
ally, the infertile upper classes are better fitted to
rear children than the prolific lower classes.

In still another physiological phenomenon we
see how Nature is out of harmony with our es-
tablished customs of civilized life. This is the
transmission to the offspring of certain age de-
fects. Nature has made it possible for mother-

The Problem of Ancestry and Environment 173

hood to begin at a period several years before a
woman may legally marry, and at a still longer
period before marriage usually takes place. In
this particular instance the man-made customs
are better than those of Nature. For the children
of extremely young mothers are likely to inherit
their imperfect development and weaknesses. So
that there is a good eugenic, as well as an eco-
nomic, reason for our laws prohibiting early mar-
riages.

On the other hand, we find that the children
of parents at the other extreme of life — children
born at the period of paternal decadence — are
somewhat more likely to show defects than those
of an earlier period, that is, between the ages of
twenty and sixty. Here Nature has set limitations
for the woman with better judgment, it would ap-
pear, than for the earlier period of life; but it
would probably be advantageous to the race if
some corresponding limit had been fixed for man.

There is nothing novel in this observation that
the children of old men are likely to be defective.
The Eomans observed it two thousand years ago,
and acting upon their observation, prohibited
marriage to a man over, sixty. But since the
period of woman's immaturity and man's decad-
ence are both relatively short, there seems little
practical need for changing or adding to our
present marriage laws as regards age limitations.

What we need in practical eugenics is enlighten-

174 Increasing Your Mental Efficiency

ment rather than laws. As soon as we have suffi-
cient positive knowledge about the practicalities
of heredity, controlling laws will follow as a
natural sequence ; and such laws will work effec-
tively. But until we have this very definite
practical knowledge, supported by comprehensive
enlightenment, we cannot hope that effective laws
will be enacted, or enforced.

vn

Increasing Our National Efficiency

AT the present time there are a number of state
•^^^ and national societies engaged in the study
and practical promotion of mental efficiency. Re-
cently two of these societies, one a national, the
other a state organization, held a joint conference
for the purpose of disseminating as widely as pos-
sible their ultimate aim — national efficiency. At
this meeting Dr. Lewellys F. Barker, of Johns
Hopkins University, made some observations on
unsoundness of mind as a national handicap that
deserve the thoughtful consideration of every per-
son interested in our national efficiency, which is
directly dependent upon the personal efficiency
of each individual. Dr. Barker's statements
were, in part, as follows :

It is believed by those who are studying the
subject that a proper application of the knowledge
already at our disposal could gradually do much
to improve the minds of the individuals who col-
lectively make up the nation. The number of chil-
dren born into the nation with defective brains
could be diminished. Through a stricter super-

175

176 Increasing Your Mental Efficiency

vision of immigrants many inferior brains could,
with advantage, be denied admission to this coun-
try. Social and educational conditions could be
improved so that the sum of the influences acting
upon the nervous systems of children, adolescents,
and adults would be more favorable to brain and
mind than now.

In the narrower sense, " unsoundness " of mind
refers to those graver disturbances of the mental
faculties which we call insanity, idiocy, and imbe-
cility. Idiocy and imbecility, due to imperfect de-
velopment of the brain, may be the result either of
bad heredity, or of serious disease in the earliest
period of life. The forms of insanity which
occur later in life may also be due in part to bad
heredity, in part to bad environment. As ex-
amples may be mentioned the insanity of adoles-
cence (sometimes called dementia praecox), the
manic-depressive insanities with their maniacal
and melancholic states, paranoia and the so-called
paranoid states, general paresis, due to syphilis,
the insanities due to alcoholism, and the insanities
accompanying thickening of the arteries of the
brain, or senility.

In the broader sense, " unsoundness " of mind
is a much more inclusive term. Thus epilepsy,
hysteria, hypochondriasis, and psychasthenia
are, in reality, conditions in which the mind is to
a greater or less extent disturbed. Even in the
conditions commonly designated as " neuras-

Increasing Our National Efficiency 177

thenia " and " nervous breakdown " the mental
functions are, usually, temporarily slightly dis-
turbed.

Again, many people seem ignorant of the fact
that mind includes not alone " intellect," but also
the " affections " and the " will "; to such people
" unsoundness " of mind means disturbances of
the reason, and it is hard for them to realize that
abnormal expressions of emotion, or disorders of
the will manifesting themselves in anomalies of
conduct, can be evidences of " unsoundness of
mind." For the medical man, however, a knowl-
edge of the perversions of feeling and of the
deviations from normal behavior which accom-
pany defect or disease, is of the greatest impor-
tance in making diagnosis of abnormal mental
states and of the disorders of brain-activity which
underlie them. It is just here that the legal con-
ception of responsibility ceases to be synonymous
with medical conceptions of responsibility — a
notable example of that ambiguity of language
which leads so often to disputes. It is encourag-
ing that even in law, which is necessarily and de-
sirably conservative, the idea of " degrees " and
varieties of mental unsoundness has in recent dec-
ades been gaining currency, and with it the
conception of " artial," " diminished," or " at-
tenuated " responsibility as well as that of the
" individualization of punishment."

If we keep in mind the fact that conduct,

178 Increasing Your Mental Efficiency

whether good or bad, is directly related to mental
states — using the term mental in the wider sense
to include all parts of the mind — will and emotion
as well as intellect — we can scarcely fail to recog-
nize the close relations which exist between
mental unsoundness (in the broader sense) and
all those forms of abnormal conduct which charac-
terize the delinquent classes. More than ever
before society is coming to recognize that the
problems of criminality, of inebriety, of vagrancy,
of prostitution, and of pauperism are closely in-
terwoven with the problems of brain disorder,
and that efforts directed toward the diminution of
the amount of delinquency will be effective only in
as far as they succeed also in improving brain
quality and brain function, that is, in as far as
they provide for better acting minds.

A Burden to the Nation

Unsoundness of mind is a burden to the nation
in more ways than one. In the first place the
economic burden is enormous. Dr. Charles L.
Dana estimated, in 1904, that the actual cost of
caring for the insane and the feeble-minded in the
United States amounted to sixty million dol-
lars per year, and that the loss to the nation in
industrial activity due to insanity and idiocy was
at least twenty million more. He believed that
the care and cost of the diseased and defective

Increasing Our National Efficiency 179

brains of the country amounted to over eighty-five
million dollars annually, and that the amount
was increasing absolutely at the rate of four per
cent. Other investigators believe that to-day the
cost is much more than one hundred millions.
And these figures, bear in mind, refer to the in-
sane and the feeble-minded only. If we add the
cost of criminals and the delinquent classes gen-
erally, the expense will be seen to be stupendous.
In addition to the economic burden we must
consider also the cost in human suffering, not only
that of the mentally unsound themselves, but also,
and more particularly, the cost in sorrow to those
to whom these unfortunates are near and dear.
This is a burden not measurable in money. This
is a load incomparably harder to bear. Some of
you who have come in contact with ill-fated
families will have learned from that contact what
I mean better than words of mine can tell.

Every Nation Bears a Similar Burden

It is calculated that some 250,000 people in the
United States are insane. The number is not
excessive when compared with the prevalence of
insanity in other countries. The number of de-
linquents of various sorts is unfortunately large
in every land. The fact is that every nation has,
at present, to bear a similar burden of insanity,
imbecility, and delinquency. How long will this

i8o Increasing Your Mental Efficiency

continue? It is impossible to say, but judging
from the alertness which peoples in modern times
manifest with regard to conditions making for
national advantage, it seems probable that stren-
uous efforts will soon be made by the more ad-
vanced and cultured nationalities radically to
reduce the load of mental disease and deficiency
by which they are handicapped. There are a good
many who hope and believe that the United States
of America will be among the first successfully to
move in this direction. Is it not probable that the
nations that remain backward in the campaign for
mental hygiene, once one or more of the great
peoples have made progress in it, will run some
risk of failure in the world rivalries in which they
may be compelled to participate?

Can the Occurrence of the Unsound Mind Be
Diminished?

Is the burden to which I have referred remov-
able ? Before answering this question it is neces-
sary to consider the origin of mental unsound-
ness. Biologically viewed, unsoundness of mind
means badly functioning brain. Now a brain may
function badly because it has a bad structure to
begin with, or because it has been subjected to in-
fluences incompatible with good functioning, or
from a combination of these two conditions.

Certain qualities of brain, which we designate

Increasing Our National Efficiency i8i

as innate, depend upon heredity, that is to say,
upon the qualities of the germ-plasms inherited
from father and mother, but the development of
the brain in the child and its functioning through-
out life are dependent also upon influences outside
itself, acting upon it. Such influences arise partly
in the body of the bearer of the brain, partly out-
side his body in the environment. This doctrine,
that the kind of mind an individual has (his
thoughts, his feelings, his conduct) depends upon
the kind of brain he is born with, and upon the
external circumstances which act upon his brain,
shows us the direction in which we must look for
an answer to our question, Is the burden of un-
soundness of mind removable?

Theoretically, the answer is obvious. We shall,
on the one hand, have to see to it that children
are born with brains of such inherent qualities as
will make them capable of development to a cer-
tain grade of individual and social usefulness,
and, on the other hand, we shall have to regulate
the influences which are permitted to act upon the
brains of children and adults so that the welfare
of their mentality shall be favored and not in-
jured.

Difficulties

The practical application of the broad prin-
ciples involved is, however, far from easy. Pro-
vision for well-bom children is the special field

i82 Increasing Your Mental Efficiency

of eugenics. The control of external circum-
stances is the problem of euthenics. But there are
barriers in the way of practical eugenics which
will be hard to pass, and the impediments to
progress in bettering environment are familiar to
every social worker. We must take care that the
cause of mental hygiene is not injured by rash
enthusiasts who propose panaceas, who promise
the unattainable, or who fanatically urge the im-
mediate adoption of ill-considered plans of re-
form. There will be plenty of distrust and
apprehension, even of the most sensible applica-
tions of sound principles. It is important,
therefore, that the advocates of mental hygiene
shall endeavor to purge their ranks of the narrow-
minded, the imprudent, and the precipitate.

A careful examination by sane investigators of
the various measures which have been proposed is
needed in order to ascertain which of them may
be unhesitatingly advised; and only with such
measures should the work of application be begun.
We possess now a large body of facts bearing
upon heredity and environment as they affect the
brain and its functions, about which there is
unanimity of opinion among men with the train-
ing which makes them competent to judge ; many
of these facts can undoubtedly be applied to the
betterment of the brain power of the nation. The
public should be systematically instructed regard-
ing such facts. Beyond this, we should be content

Increasing Our National Efficiency 183

with stirring up interest in the general subject
and with the stimulation of researches which may
bring us more definite information to be used
later on.

To recapitulate, then, unsoundness of mind in
its various forms is alarmingly prevalent in this
and in all civilized countries. It is veritably a
heavy burden borne by every nation. Its occur-
rence can be and should be diminished. There are
difficulties in the way, but they must be overcome.
For the present, we can do most by stimulating
investigation and by educating the public regard-
ing well-established facts. Surely, the work is
wide and noble in its purpose. It is worthy,
surely, of the devotion and enthusiasm of our
most patriotic citizens ; in such work they can find
ample opportunity for the exercise of their high-
est faculties.'

Early Manifestations of Mental Disorders

There are two methods of making the reader
familiar with the symptoms of certain well-de-
fined and important forms of mental disorders
that may at any time come under his observation.
One method is to describe these conditions in a
general way ; the other is to select individual cases
and describe their symptoms in detail.

' From an address on " Unsoundness of Mind, a National Handi-
cap," delivered by Prof. Lewellys F. Barker before the Mental
Hygiene Conference, New York City, November, 1912.

1 84 Increasing Your Mental Efficiency

In the earlier chapters I have given a general
survey of certain forms of aberration, as a
familiarity with general conditions is desirable,
and necessary, if the peculiarities presented by
individual cases are to be fully appreciated. But
having thus touched upon the general features of
the subject, it seems advisable to consider some-
what more in detail certain mental states that are
peculiarly prevalent at the present time.

In a recent address Dr. August Hoch, Professor
of Psychiatry, Cornell University Medical Col-
lege, presented some features of this subject in
such a masterful way, and in a manner so entirely
comprehensible to the general reader, that I take
the liberty of quoting him at length.

Mental hygiene, said Dr. Hoch, has many points
of contact with hygiene in general, not only in the
sense that the bodily condition, naturally, reflects
upon the mental state, but also in the sense that in
the prevention of insanity a considerable portion
of our task does not belong, strictly speaking, in
the realm of mental, but in that of general,
hygiene. It is necessary to constantly repeat that
insanity is not one disease but a comparatively
large number of diseases or disorders which dif-
fer widely, not only in their manifestations but in
their causes ; so that in everything which refers to
the practical dealing with treatment and preven-
tion we have to follow quite different principles
in the different kinds of diseases. In some of

Increasing Our National Efficiency 185

these diseases we are dealing with plain physical
causes or conditions, such as syphilis, diseases of
the blood-vessels, the premature wasting of brain
tissue in advanced years, or we are dealing with
alcohol or other poisons introduced into the body.
The prevention of some of these diseases which,
in part at least, have clean-cut causes, is theoretic-
ally simple and the task before us clear enough,
as clear as it is, for example, in tuberculosis.
That nevertheless even in these disorders the task
is a difficult one, is due essentially to such human
factors as ignorance, selfishness, and prejudice.

In the organic mental diseases the early mani-
festations are much more an integral part of the
disease ; they indicate the beginning of the actual
breakdown, they represent the first indications
that a severe brain disease has started. On the
other hand, in the other group of mental disorders
we find frequently even in early childhood, or at
the age of puberty, or during adolescence or later,
here and there certain peculiarities of character,
certain defects of self-management which we must
regard as danger signals and which should be
taken much more seriously than is commonly the
case. Such evidence we psychiatrists have
learned to recognize, above all, through careful
inquiries into the life histories, the characters, the
habits of those individuals who are brought to us
after the mental breakdown has occurred. And
the conviction has more and more been borne in

i86 Increasing Your Mental Efficiency

on us that the public and, above all, the physicians
have not paid enough attention to such signs, and
that a better knowledge of these early danger sig-
nals should be useful to all those who have to deal
with children and young people.

Of course one might ask then, whether we have
a right to speak of such danger signals as early
manifestations of insanity at all. It might be
said that these are essentially defects of constitu-
tion, of make-up, of habits, and moreover,
defects which need by no means always be fol-
lowed by insanity. And it might further be
said that, in treating of these more particu-
larly, we are really not talking on the sub-
ject which was announced. But whether or
not we should regard such signs as true early
manifestations is, after all, a purely academic
question which sinks into insignificance beside the
essential question, namely: what is of practical
importance ? and from that point of view it seems
to me that these earliest signs deserve more par-
ticularly to he pushed into the foreground. How-
ever, they undoubtedly represent unhealthy ways
of living, and, though they may be, and undoubt-
edly are in part, the expression of a poor endow-
ment, there is, we are convinced, much in them
which, through better understanding, through the
fact that our attention and our studies are di-
rected to them, we shall learn to manage better.
"While there has been a certain tendency, on the

Increasing Our National Efficiency 187

one hand, to disregard these earliest manifesta-
tions of insanity, there has also been, on the other
hand, a tendency to emphasize unduly heredity
and degeneracy as unalterable factors in the in-
dividual which lead to a somewhat fatalistic sizing
up of the situation. There is much which goes to
show that such a view is one-sided, and we hope
that the future will prove that it is unnecessary.

Two ways are open to treat the subject in hand.
Either we might give you a summary of observa-
tions which have been made in regard to these
earliest signs of lack of mental balance, or we
might briefly consider some concrete instances,
some living examples of individuals, some life
histories which illustrate definite defects which
were present for years or throughout life, and
which show clearly that the breakdown did not
come out of the clear sky but was rather an event-
ual outcome of inadequate self-management and
inadequate management by the environment — to
be sure in addition to a certain weakness inherent
in the individual. I shall choose the second
course, and briefly make you acquainted with some
actual observations.

The first patient is a young woman, about whose
early life we are fairly well informed. We are
told that even as a child she was hard to manage
and took advice badly. While I cannot find any
very concrete examples or instances under which
this behavior manifested itself, the notes give

1 88 Increasing Your Mental EfBciency

enough to show that the difficulties which the
parents and teachers experienced in managing the
child were not due to any very active traits on the
part of the latter, not to that kind of boisterous
childish vivacity which is seen in normal children
who are hard to manage ; but rather to a passive
resistance. She got along pretty well when left
alone, but even simple adaptations were difficult
for her. Thus it troubled her when her things
were touched, or when she was interfered with
in any way. Her reaction then to such interfer-
ences was, however, not an aggressive one from
which a certain healthy shaping of the situation
might be expected, but a rather fruitless irrita-
tion, and more particularly, as is stated, a ' ' going
off by herself. ' ' Again, and quite consistent with
what we have said, we are told that she played lit-
tle with other children, was apt to cry when things
did not go just her way, and then left her play-
mates. It is also specifically said that she was not
liked by others. Children have a quick apprecia-
tion of barriers which another child, or for that
matter an adult, erects about him, and shun that
kind of personality. In company she was silent,
took no part in what was going on, and very often
left the room. She seemed ill at ease and bashful.
But she was not stupid, on the contrary rather
above the average in intelligence, and she worked
hard at school and had good marks.
At sixteen she became over-religious, a change

Increasing Our National Efficiency 189

which was not accounted for by anything that
happened in her environment. Then came a year
at business college, which, so far as the work was
concerned, was also passed satisfactorily, though
her general traits did not change. But when the
time came to use her knowledge, that is, to change
from a mere receptive situation, which makes
infinitely less demands than the much more diffi-
cult task of stepping out into the world of respon-
sibility, then she was unprepared and shrank from
it; instead of taking positions which, evidently,
under the force of example and promptings from
home she did seek for a time, she found fault with
every one, and remained inactive. She married at
eighteen, and after the birth of the first child de-
veloped a serious mental disorder, from which she
has not and will not recover.

A somewhat similar situation is seen in the fol-
lowing patient, though here the gradual changes
are more plainly shown. This patient is described
as a girl who was also shy and retiring, inclined
to be afraid that what she did she did not do right,
afraid that she was not obedient enough, and she
was apt to tell other children to be more obedient.
Though she had the opportunity, she did not play
much with others, but preferred to be by herself,
and somehow she was always unable to get into
real contact with those about her and to derive
satisfaction from this. Yet she, too, was quite in-
telligent and good at school.

igo Increasing Your Mental Efficiency

When puberty came on, with its physical
changes, she was unable to take this naturally and
had warped ideas about it. At fifteen, though she
continued to look healthy and was a rather strap-
ping girl, she began to sleep badly and appeared
more absorbed. She also became fault-finding,
dissatisfied; and even when changes were made
according to her wishes, this did not bring satis-
faction and she could not be aroused. This had
been the case during the summer. When she went
back to school it was soon found that she worked
badly, but it was months before the mother made
inquiries at the school, and then she was told that
the child acted funnily, got rattled, and was the
laughing-stock of the class. She was taken home.

Then attempts were made to divert her by tak-
ing her to parties and theatres, which, however,
in her condition, did not improve matters. Again
some months passed without any one suspecting
anything more serious, until suddenly she made
a strange remark. But this was soon forgotten,
and when vague thoughts and quandaries ap-
peared about the meaning of life and death, about
the universe, and so on, they were not regarded
as especially important or strange in a 15-year-
old girl. However, the catastrophe was now not
very far off. After a while she suddenly turned
against her mother, spoke of the devil being after
her, and finally got into a state of frenzied excite-
ment. When she was finally brought for treat-

Increasing Our National Efficiency igi

ment she was in a stupor-like state in which her
interest and her contact with the environment
were extremely interfered with, a state in which
she had completely turned inward, so to speak,
and from this she has never and will never
emerge.

Somewhat different is the following ease, that
of a girl whose early history presented nothing
very striking. It is said, however, that she always
ohjected to control of any sort, but she got along
fairly well until some six or seven years before
the marked mental symptoms appeared, that is to
say, she got along moderately well until her nine-
teenth year. At that time she went to a Normal
school. There she was moody and unnatural,
was given to all sorts of fads about her diet, which
is always to be looked upon with some suspicion.
She felt tense, complained of cold feet and various
digestive disturbances. In order to escape this,
as she herself says, she lived a rather dissolute
life for a time but, of course, without getting any
real satisfaction from it. Later she began to
study music but developed again what was called
neurasthenia, was dissatisfied, uncomfortable,
tense. Again, she made faddish attempts at treat-
ment, this time by all sorts of absurd relaxation
exercises which, of course, did not go to the root
of the matter, and at the same time she lived in
an environment in which vague thoughts pre-
vailed, while balance and robust common sense

192 Increasing Your Mental Efficiency

were lacking. Suddenly tlie outbreak came when
she proposed to a man whom she knew but
slightly. She rapidly lost weight, thought she
was married, and her conduct, in other ways, was
absurd.

The following instance I desire to speak of, not
because the patient showed similar traits in her
earlier life to those already mentioned, but be-
cause it is an excellent example to show how
poorly understood were the danger signals, even
when they appeared in a very marked form, and
just how that step was taken which, above all,
should have been avoided. The situation was
this: A predisposed girl begins to show mental
symptoms when she becomes engaged. Neverthe-
less she is allowed to marry, and upon this the
psychosis at once breaks out full-fledged. The
patient is a girl of 22. She was not very bright
at school; sometimes when the teacher asked her
questions she gazed at her without answering.
But on the whole she was not very peculiar, not
decidedly unsociable. Frona the seventeenth year
on, however, a change came over her and she then
became more reticent and less sociable. Seven
months before admission she became acquainted
with a man, is said to have become very much in-
fatuated with him, and got engaged after a short
acquaintance. Soon after this she began to show
an indefinite fear and, having lived away from
home, she now returned to her parents' house.

Increasing Our National Efficiency 193

She soon developed fancies, thought her fiance
might come after her with a knife. She had cry-
ing spells without saying why, was morose, and
asked her sister to chop her head off.

In spite of this plain beginning of the psychosis,
as we have said, she was married some weeks be-
fore admission, and very soon got much worse
and developed a grave psychosis from which she
will not recover. Now, any one who is at all ob-
servant would have been struck by the fact that
definite symptoms appeared when she became en-
gaged. This should have been a warning, but of
course it was not a warning because no attention
is paid to such things, very often not even by
physicians. To a psychiatrist the situation would
have been very plain, for not only did she show
mental symptoms, but mental symptoms which
directly pointed to the fact that they were con-
nected with a lack of adjustment to this marriage,
although this, to be sure, was not conscious.

The popular belief that marriage cures nervous
and mental trouble, a belief which is not only
common among the laity, but also among doctors,
is a dangerous one. It is precisely a question of
defects of sexual adaptation which are so common
among these individuals, and therefore we should
do everything we can to eradicate this belief.
That it exceptionally holds good must be admitted,
but usually the opposite is the case, and I could
cite many instances in which the advice to marry

194 Increasing Your Mental Efficiency

was full of serious consequences in individuals
who were predisposed. The psychosis broke out,
as was to be expected, with a peculiar attitude
towards her husband and she was afraid of him
and began to doubt whether he was her husband,
and in other ways showed that she was utterly in-
capable of this adaptation which was demanded
of her by the marriage.

These characteristic cases must suffice to show
some of the traits which patients who develop in-
sanity presented long before a breakdown was
thought of. It is surprising how rarely we find
that any such calamity was expected, even when
the indications became only too plain. The stories
which I have presented refer to that form of men-
tal disorder which we call dementia prsecox, or, at
any rate, to disorders closely related to this. I
shall presently try to make clear what is meant
by this disease. For the present it seems not out
of place to state that the yearly admissions to our
hospitals which belong to this general group,
represent nearly a quarter of all the cases ad-
mitted, and to further state that it is a conserva-
tive estimate when we say that the New York
hospitals for the insane at the present moment
take care of about 15,000 such patients, that is,
half the inmates of all the institutions.

And now as to the meaning of this condition:
We are becoming more and more convinced that
some mental disorders are reactions of a similar

Increasing Our National Efficiency 195

nature, as we find in normal people ; and, as in the
normal these reactions to life are adjustments, so
are these mental diseases attempts at adjustments,
but no longer adjustments which take account of
the facts, or of the world as it is, but fictitious ad-
justments — they are poor instinctive attempts at
getting satisfaction which life did not furnish,
partly on account of the inherent difficulty in the
individual to accomplish proper adaptations to
the difficult business of life, but partly also, as we
have said, on account of often unnecessarily poor
self -management on the part of the individual, or
defects in the environment. Hence, we are learn-
ing to understand many even grotesque manifes-
tations of insanity.

We can, when we are able to penetrate into the
devious trends of thoughts and feelings of our
patients, see a meaning and a purpose in them.
But it is precisely this which gives us the convic-
tion of a continuity between the personality, with
its faulty self-management before the mental
breakdown, and the disease proper. But it also
gives us the conviction of a continuity of these
forms of insanity with milder forms of mental
disorder which are not called insanity, or with
neurasthenic and nervous states, or with the in-
ternal disharmonies of many so-called normal
people. The nervous person of any kind is some-
what out of touch with his environment and does
not get his full satisfaction out of life; we find

igS Increasing Your Mental Efficiency

that those natures are most in danger of breaking
down with dementia praecox in whom the interfer-
ence with the proper touch with the environment
is most marked. They are natures who turn away
from reality, who shun the more difficult adapta-
tions to life. And, when we analyze the symp-
toms of this disorder, we find that they are essen-
tially the expression of this attitude of turning
inward and the growth of fancies which in-
variably result when the interest in the real world
stops.

We have seen that the chief early manifestations
in this group of diseases, the chief characteristics
of the persons, were those of reticence, seclusive-
ness, stubbornness, brooding, sensitiveness, a cer-
tain suspiciousness, together with oddities and
strange behavior. Such peculiarities, which have
their causes not only in unalterable innate per-
sonal traits, have a tendency to grow. It is not
surprising that such persons should (be found
unprepared when adaptations to new situations
are required through internal or external changes
as those which come with puberty, with stepping
out into life, with marriage, etc.

Dementia praecox is not the only disorder of
which I wish to speak. A similar number of ad-
missions to the hospitals is furnished by those
forms which we call mania and melancholia, dis-
orders which may be regarded essentially as exag-
gerations of normal emotions. These diseases are

Increasing Our National Efficiency . 197

less serious. They are apt to begin much more
abruptly and, as a rule, they lead to recovery;
though relapses are common which, however,
again tend to the reestablishment of the normal
state. A considerable number of these disor-
ders occur in later life, especially melancholias.
In harmony with the better outlook of these dis-
orders we find the fact that the individuals who
develop them are much more natural, though we
find among them many who habitually have a
tendency to look on the dark side of life, or we find
slight traits like those mentioned above, or ner-
vousness, or emotional instability, or other traits.
I cannot refrain mentioning here a case which
belongs in this group, a case which may serve to
show how an early treatment would have avoided
more serious consequences. The patient is a
woman of 31, who, though not very bright, was a
conscientious worker in a shop. She always wor-
ried a good deal, cried easily. She was called a
home-body and had little association beyond that
of her mother. A young man called on her occa-
sionally for a number of years. For a year he
did so more frequently and finally spoke of an en-
gagement. Nine months before admission the pa-
tient had found out that he was already engaged.
She was much upset, cried, walked the floor, slept
poorly, said she had nothing more to live for, and
was unable to work. Now, this patient should
have been placed under treatment at that time

igS Increasing Your Mental Efficiency

when the condition was one of a simple depression
well accounted for. Instead of this she was kept
at home. She did improve a little, but friends
kept telling her all about the man's doings, that
he was married, and so on, and her worry again
increased, and finally the mental disorder took a
more serious form — a sudden change came over
her, a change which she expressed by saying that
she had no feeling.

Under observation she complained essentially
of this change, said she was not herself, her body
was changed, her head empty, and she was very
much agitated. This is a well-known condition
and one from which the patient will finally re-
cover, but is one which is more serious than the
one she had presented at first and one which is
apt to last much longer. It could plainly have
been avoided if the public fully appreciated that
treatment should be instituted earlier in the at-
tack and not only when the condition is so ad-
vanced that we have gone beyond the point of elas-
ticity, or that at any rate very much less can be
done than would have been possible at first. The
case teaches some other lessons, but I fear it
would take too long if I were to go into details.

And it is not insanity only of which we should
speak in this connection. We have already men-
tioned the fact that there is a continuity between
these forms of insanity and milder abnormalities.
Here all sorts of nervous symptoms should be

Increasing Our National Efficiency igg

mentioned: moodiness, depression, insistent
doubts and uncertainties, abnormal lack of deci-
sion, unfounded suspicions, uncalled-for feeling
of being at a disadvantage, feelings of inferiority,
exaggerated anxiousness and timidity, sexual un-
certainties and doubts, visionary tendencies, pe-
culiarly warped mental attitudes and many oddi-
ties of behavior, etc. Although many such people
do not break down, they often suffer enough.
Think of the colossal amount of energy which is
expended in their struggles and taken away from
useful activity, and think of the trouble which
some of them make in the world and the hardship
which they impose upon others, and yet many of
these traits are often regarded, I might say, as
legitimate traits, or at any rate as traits which
are the expression of such and such a personality,
and therefore are looked upon as settled.

It is not within the scope of a paper which is
supposed to call attention essentially to the early
manifestations of insanity, to speak at length of
remedies. And, moreover, I could not offer any
simple means of combating all these ailments of
which I have spoken this evening. They are the
outcome of many internal and external factors
and each case is a problem by itself. All treat-
ment, even that with medicines, consists in the
application of two principles — that of training
and that of rest. It is not different from these
nervous conditions. Here the principle of rest, or

200 Increasing Your Mental Efficiency

of relieving the strain, consists in getting below
the surface, in trying to find out what are the
real causes of these peculiarities of feeling and of
behavior, what are the conflicts, the internal atti-
tudes and ideas of the individual; and the same
principle also takes into account the correction
of wrong influences of the environment.

Reconstructing the Mental Attitude

The principle of training, on the other hand,
is represented by the teaching of healthy living
under reconstructed conditions. All this is a task
which may be quite laborious and which requires
skill and knowledge. But one thing is certain and
that is that not only are too few attempts made
in this direction, but the danger signals as a rule
have not even been recognized, or have not been
regarded as such, and nothing at all has been done
to modify them. We have looked upon them, as
I have said, rather as legitimate traits which this
or that person also presented more or less, with-
out coming to serious grief. What must be de-
veloped is a feeling that all these traits are impor-
tant and are to be taken seriously. We must learn
that even slight abnormalities of self-management
or conduct are matters which need to be dealt
with, as matters which not only interfere with the
full development of the personality, of which we
are all so much in need, but which later may lead

Increasing Our National Efficiency 201

to more serious consequences, and while it is diffi-
cult to give simple uniform ways of handling
these conditions, they will nevertheless at times
be found to be much more manageable than would
seem, especially when taken early. Many people
often stand at crossroads; in one direction lies
health, in the other nervousness or perhaps in-
sanity. Many turn in the right direction from
innate sense, others turn the other way because
they are constitutionally doomed. But we are
sure that many could be guided better if we only
paid more attention to these nervous conditions,
and would be thoroughly impressed with the fact
that they are wrong, to say nothing of the neces-
sity of getting away from a certain admiration of
some of them. It might of course be justly stated
that much good also comes from people who have
certain nervous tendencies, indeed that it is in
part these tendencies which create the good. But
this is true only of those individuals who find,
from their disharmonies and conflicts, a way
toward altruistic or artistic pursuits of value,
therefore a way toward adaptation after all.
This of course is the cause for our admiration of
nervousness which for that reason has a certain
justification, but that should not prevent us from
pointing to the dangers as well. This is one of the
tasks of the mental hygiene movement — to call at-
tention to these conditions. What the future will
have to bring us is the development, gradual to

202 Increasing Your Mental Efficiency

be sure, like all healthy developments, of provi-
sions for a better management of not only the
intellectually defective, but the nervously abnor-
mal children. But mental hygiene should begin
even earlier in life, namely, with the infant, and
we should constantly insist on the importance of
the early years of life for the formation of char-
acter and modes of reaction, and upon the neces-
sity of paying much more attention to these years
of infancy and early chilhood from the point of
view of mental hygiene.

But we need also much further study along
these lines, and intensive occupation on all sides
with the question of nervousness and peculiarities
of behavior. We need more and more a psy-
chology which will occupy itself with character
formation and with the individual and its strag-
gles and disharmonies, and, on the part of the
school, an appreciation that dry knowledge is not
the only thing that is needed, but training to
efficiency, and efficiency on the level adapted to
the individual, at the bottom of which lies
adequate self-management.^

Syphilis and Insanity

The relationship of venereal diseases to certain
forms of mental unsoundness has been referred

' From "Early Manifestations of Mental Disorders," an ad-
dress delivered by Dr. August Hoch before the Mental Hygiene
Conference, New York, 1912.

Increasing Our National Efficiency 203

to somewhat at length in an earlier chapter. But
as the subject is one of the most important in the
field of mental hygiene, it merits the fullest con-
sideration, particularly since recent discoveries in
science have given us the means of detecting the
presence of the specific germs that cause the
initial disease, and of eliminating them from the
system.

At the recent Mental Hygiene Conference, Dr.
George H. Kirby, of the Manhattan State Hos-
pital, presented some features of this subject in
a way that it has seldom been presented to a body
of laymen by an acknowledged authority. With
Dr. Kirby 's permission I have incorporated a por-
tion of this important paper in this chapter.

In referring to syphilis and insanity Dr. Kirby
says : The subject deals with one of the most im-
portant, as well as one of the most clearly defined,
problems to be found in the entire field of mental
hygiene. It is a problem, however, which, in
common with all others that come closely into re-
lation with the sexual life, has been always
tabooed as a subject for frank discussion in open
meetings, and likewise strictly excluded as unfit
to be mentioned in the public press, except under
veiled statements or by mere allusion.

Physicians have, therefore, in the past had little
opportunity to present to the public even the sim-
ple established facts of the case made out against
syphilis as a cause of insanity. Happily there

204 Increasing Your Mental Efficiency

are at the present time many indications that this
" hushing up " and " keeping quiet " policy will
not much longer block the way against the en-
lightenment and proper education of the people
regarding the part played by this venereal disease
in the production of mental unsoundness.

In order to approach this whole subject of the
syphilitic caused diseases fairly one must guard
against a certain attitude, founded on error, yet
all too prevalent in the popular mind: many in-
telligent persons not only have no interest in the
social problem of syphilis, but they feel little or
no sympathy for individuals who suffer as a re-
sult of syphilis. There is often something of the
feeling that these people are afflicted because of
wilful transgression of religious and moral laws.
Many think only of the disease as something ut-
terly loathsome, associated always with vice,
crime, and the lowest sort of moral depravity.
This, as every physician knows, is untrue. While
prostitution is the chief means by which syphilis
is disseminated, its victims are claimed in every
stratum of society from the highest to the lowest.
Among the men admitted to the hospitals whose
insanity is due to a syphilitic infection, 75 per
cent, of them are married men, most of whom, if
guilty of transgression in earlier years, have long
since mended their ways and settled down to a
moral family life.

Among men, particularly young men, ignorance,

Increasing Our National Efficiency 205

thoughtlessness, submission in a moment of weak-
ness, and the influence of suggestion by compan-
ions, account for the wrecking of many a life.
Temptation comes to almost every man. Igno-
rance and a wholly wrong attitude towards the
sexual instinct make the fall easy for many. One
is amazed to hear young men speak lightly, or
even jokingly, of venereal disease with no knowl-
edge of what the results may be if this disorder
is once contracted.

I could quote to you many cases from my per-
sonal knowledge of young men and even boys who
acquired syphilis more or less accidentally with-
out ever having been instructed or warned of the
danger to which they exposed themselves. We
have a patient in the hospital at the present time
whose insanity is due to syphilis contracted when
he was fourteen years old, at an age when he
knew nothing of venereal diseases and had no
realization of the possible consequences of an act
which he was induced to commit by a person he
accidentally met.

It is not within the scope of my paper to dis-
cuss the wider social aspects of syphilis or the
best means of combating the evil, nor shall I at-
tempt to recount the multitude of diseases which
it causes and the consequent suffering and misery
which it brings to innumerable homes and fam-
ilies. My task is to present to you briefly what
we now know regarding the damage done by

2o6 Increasing Your Mental Efficiency

syphilis in one particular direction, namely, in the
production of mental unsoundness. It will, how-
ever, be necessary for me to say a few words re-
garding the nature of syphilis and its mode of
transmission in order that you may appreciate
fully the problem which confronts us.

A Germ That Causes Insanity

Although this disease has been described and
studied by physicians for centuries, its true cause
has only recently been definitely established.
Syphilis is now known to be an infectious disease
caused by a germ, a micro-organism, which has
been identified and its characteristics well studied.
Syphilis spreads in two ways: it is transmitted
from parent to child or it is communicated di-
rectly from one person to another during the
sexual act. Occasionally, one might say rarely,
it is communicated by accidental contact in other
ways. On the parts of the body exposed to the
infection the signs that the poison has entered the
system may be so slight as to pass almost un-
noticed ; if, as is usual, a small sore occurs it tends
to heal up rapidly with little indication of the
direful results which may follow. The germs
having once gained entrance into the system, any
part of the body or any organ may later be at-
tacked and partially or completely destroyed. By
appropriate treatment we may, however, as a

Increasing Our National Efficiency 207

rule, control the symptoms that arise within the
first few years after infection takes place, and it
may appear that the disease has been eradicated
from the body. It is, however, well-nigh impos-
sible to say that this has been actually accom-
plished, for the syphilitic germs possess the re-
markable property of lying dormant for a long
space of time, often many years, and then begin-
ning to cause trouble again.

This peculiar tendency of the syphilitic germ to
remain quiescent for years while all obvious
symptoms of the disease disappear, served to keep
us long in the dark regarding the true cause of
some of the most serious nervous and mental
troubles with which physicians have to deal. It
was naturally difficult to establish a connection
between a nervous or mental breakdown 10, 20 or
30 years after a venereal disease when, during all
these years, there had been few, if any, signs that
the syphilitic poison was still in the system. For-
tunately for our better understanding of these
diseases, which develop years after the initial in-
fection, the missing link in the chain of evidence
against syphilis has recently been supplied and
we can now present conclusive evidence, whereas
we formerly spoke merely of probabilities and
could not prove what we suspected.

The proof was furnished by the discovery of a
very delicate blood test now known the world over
under the name of the physician who devised it

2o8 Increasing Your Mental Efficiency

as the Wassermann test for syphilis. By this test
one can, through examination of a few drops of
blood, determine whether or not any trace of
syphilitic poison exists in the body of the person
tested, and this in spite of the fact that the
syphilis may have been acquired many years
previously and the individual, at the time of the
test, may present no visible symptoms of syphilis
itself.

Smouldering Fires

Among the syphilitic diseases, there stands out
one in particular that, above all others, commands
our earnest attention, first, because of its great
frequency and, secondly, because it is not amen-
able to any known treatment; the result always
being death and that usually within two to five
years after the disease is recognized. This affec-
tion is variously known as paresis, general
paralysis, or softening of the brain.

Paresis, or as it is sometimes called, par-e-sis,
develops most often 10 or 20 years after the
original syphilitic infection, and as most individ-
uals who contract syphilis do so in the earlier
years of manhood or womanhood, paresis will
appear most often between the 35th and 45th
years, just the age at which one is considered to
be in the prime of life. Thus we find that appar-
ently robust, normal individuals are stricken in
the midst of an active life. The one attacked may

Increasing Our National Efficiency 209

have almost forgotten the syphilitic infection of
years before and the patient as well as the family
and friends are sure to attribute the breakdown
to some more recent occurrence, such as over-
work, business worry, intemperance, accidental
injuries, etc., things which we now know can never
alone produce paresis.

The disease comes on, as a rule, slowly; the
finer feelings and the higher mental functions suf-
fer first; slight changes in disposition or charac-
ter are noticed, the ethical sense is impaired, rea-
son and judgment are insidiously undermined,
and very often, before the family or friends are
aware that actual mental disease exists, the af-
flicted individual has committed acts which too
often extend in their consequences far beyond the
patient himself, and may bring ruin upon his
family and others. As the mental symptoms be-
come more marked the patient's mind is apt to
be filled with all kinds of impossible schemes and
extravagant ideas, the judgment is abolished and
the memory is slowly lost, so that the patient may
finally have little knowledge of his past life. In
the terminal stages the greatest possible degree of
mental decay is reached — the patient being re-
duced eventually to a mere vegetative existence,
with little or nothing left to show that the sufferer
was once an intelligent being. Accompanying this
mental deterioration there are well-marked phys-
ical symptoms; the limbs tremble, the power of

210 Increasing Your Mental Efficiency

speech is impaired, convulsions may occur, the
patient becomes bed-ridden from weakness or
paralysis, and so remains until death finally closes
the distressing scene.

The post-mortem examination of the body
shows us that the syphilitic poison has caused
widespread damage to the brain, the result of a
chronic inflammatory condition accompanied by
softening and shriveling of the brain matter itself.

Recently a very important remedy known as
" 606," or Salvarsan, has been brought forward
as a cure for syphilis. It appears to have a very
remarkable effect in checking various syphilitic
symptoms, particularly those that develop soon
after the primary infection takes place, but un-
fortunately we find that it is of absolutely no use
in the treatment of paresis.

During the past year 758 patients entered the
New York State hospitals suffering from paresis,
which number is equivalent to nearly 14 per cent,
of all the 5,700 new cases admitted. These 758
persons represent only a part of the cases of
paresis that develop in the population, as many
patients are sent to private institutions, others
are kept at home, and some die in general hos-
pitals. Among all the admissions to the State
hospitals we find, with one exception, more cases
of paresis than any other single form of mental
disorder.

Paresis is much more frequent among men than

Increasing Our National Efficiency 211

among women — three times as many men as
women are admitted suffering from this disease;
we find that 18 to 20 per cent, of all men admitted
are suffering from paresis.

It is also known that paresis is much more prev-
alent in cities than in country districts. Among
all the admissions to the State hospitals we find
that 22 per cent, of the men who come from cities
have paresis, while only 8 per cent, of those who
come from the country have this disease. The
women show a similar difference, as we find twice
as many cases of paresis among city-women as
among country-women. These figures show
clearly that syphilis is more frequent where the
population is most compact.

Another interesting and important fact is that
paresis is much more prevalent among the
foreign-born population than among the native-
born inhabitants. In New York City, for instance,
we find that when we compare the foreign-born
with the native-born population, there are propor-
tionately twice as many cases of paresis among
foreigners as there are among the natives.

Last year 627 patients died of paresis in the
New York State hospitals. As had been pointed
out by Dr. Salmon, this large number of deaths
takes rank with the mortality rate of some of the
most dreaded diseases. Typhoid fever is one of
the most feared and widespread of the infectious
diseases, yet in this State paresis causes over half

212 Increasing Your Mental Efficiency

as many deaths each year. Paresis claims more
victims annually than does erysipelas, one of the
most common of infectious diseases. Cancer of
the breast, a frequent and malignant disease,
causes yearly no more deaths than paresis. Sta-
tistics show that in this State more deaths result
each year from paresis than from dysentery,
malaria, smallpox, tetanus, and rabies all com-
bined.

These hundreds of cases of paresis that stream
into our hospitals every year represent only a
part of the damage that syphilis causes to the
mental health of the community. Thanks to the
Wassermann blood test and other investigations,
we can now definitely state that syphilis is re-
sponsible for many other conditions of mental
unsoundness.

The Penalty of Inherited Syphilis

In the first place, some very interesting studies
have been made on the families of paretic pa-
tients. We find that when either the father or
the mother suffers from paresis many other
members of the family may be infected with
syphilis, and furthermore, we find that a sur-
prisingly large number of children in these fam-
ilies are feeble-minded, nervous, or in other ways
abnormal. Dr. Plaut examined a group of 100
children, the offspring of cases of paresis, and

Increasing Our National Efficiency 213

found that 45 per cent, were plainly damaged
mentally or physically or in both fields ; the blood
test showed that one-third of these 100 children
had the syphilitic poison in their systems.

Another investigator found in a group of 139
children, the descendants of parents who had
syphilitic nervous disease, that over 25 per cent,
were definitely feeble-minded or affected with
some serious nervous disorder.

Other studies indicate that there exists a close
relation between syphilis and many of the hitherto
unexplained cases of feeble-mindedness, including
idiocy, imbecility, infantile paralysis, and some
forms of epilepsy. While the question is not
yet settled, it appears that syphilis is the real
cause of many of these cases of mental defect in
children.

A striking example is furnished by the record
of a family studied by Dr. Plant. A thirteen-year-
old schoolboy was brought to the hospital because
he had a convulsion while at school. Examination
showed that he was a case of juvenile paresis in
the early stages, the blood giving the usual indi-
cation of syphilis. His parents were questioned,
but both denied positively that they ever had
syphilis. The father would not allow his blood
to be examined, but the mother permitted the ex-
amination, and she was found to have syphilitic
blood, although at the time of the test she ap-
peared to be in good health and claimed to have

214 Increasing Your Mental Efficiency

no knowledge of ever having had syphilis. The
four other children in the family were then ex-
amined. Two were found to be feeble-minded and
the blood test was positive for syphilis. A third
child had previously been treated for a syphilitic
skin disease, and the blood test was again positive.
A fourth child appeared well and the blood test
was negative. It was thus found that in a family
of five children the blood test was positive in
four, and three of these were mentally abnormal.
The mother also had syphilitic blood, although
she did not know that she had ever contracted
syphilis, while the father, who was probably the
cause of all the trouble, would not submit to a
test.

Such observations as this are particularly in-
structive, because if the family had not been care-
fully examined and tested for syphilis, the true
reason as to why the children were mentally ab-
normal would not have been discovered.

In another group of cases of mental disorder
due to " syphilis of the nervous system," one
finds that the disease has directly attacked the
coverings of the brain and the small blood-vessels,
and inflammatory deposits occur which do serious
damage to the brain substance and consequently
impair the mentality.

A very frequent disease is arteriosclerosis, or
hardening of the blood-vessels, a certain number
of cases of which are caused by syphilis. When

Increasing Our National Efficiency 215

the blood-vessels of the brain are attacked very
serious mental decay may result. We thus find
that many middle-aged or older persons may
suffer strokes of paralysis or have convulsions
and become insane or demented as a result of the
injury that syphilis does to the arteries of the
brain.

When we know the grand total of all of these
conditions of mental defect and disease, as repre-
sented by the hundreds of cases that are received
every year in the State hospitals and institutions
for the mentally defective, we do not even then
gain a correct idea of how great a menace syphilis
is to the mental health of the nation. Still the
figures which I have quoted to show the actual
number of cases of insanity due to syphilis ad-
mitted to the State hospitals, should impress
every thoughtful citizen with the urgent need of
lending his or her efforts to the solution of this
problem. As matters now stand, we know that
just as many hundreds of cases, and more, will be
admitted to the State hospitals next year as in
the year now passing.

Every parent and teacher, every spiritual and
moral adviser, should not fail to see that every
youth is warned and properly instructed before
the temptations of the world are faced.

Physicians are almost unanimous in their belief
that the first great step will be taken toward the
prevention of insanity from syphilis and the con-

2i6 Increasing Your Mental Efficiency

trol of the disease itself when we begin to treat
syphilis as we do other infectious or contagious
diseases. We protect the community against
smallpox, diphtheria, scarlet fever, tuberculosis,
and other communicable diseases by reporting
them to the Board of Health and fighting them by
quarantine, isolation, disinfection, and all other
means within our power. Why should syphilis, a
dangerous, contagious, and infectious disease, be
excepted? For the protection of the community
every person infected with syphilis should be
registered with the health authorities and proper
means taken to limit the communication of the
disease to others. For the protection of families
and for the ultimate improvement of the race,
no person who has had syphilis should receive a
marriage certificate unless the blood test proves
that the poison is no longer in the system.

When we deal with syphilis in this manner, then
will the number of cases of hopeless insanity be-
gin to decrease, and fewer feeble-minded children
will be bom into the world. ^

Educational Methods and Mental Efficiency

The question of mental efficiency is determined
by two great factors: natural endowment, and
education. The first is entirely beyond our con-

1 From an address on " Sjrphilis and Insanity " delivered by
Dr. George H. Kirby before the Mental Hygiene Conference, New
York, 1912.

Increasing Our National Efficiency 217

trol in the present generation of cMldren. But
the second is well within our power to direct.

Until recently educational methods have been
left largely in the hands of lay-teachers engaged
in the didactic work of the schoolrooms. But it
is obvious that these teachers should include in
their special instructions the general features of
mental hygiene that have been investigated by
persons specially engaged in that part of our
education that applies to mental stability. This
can only be done in a general way, of course, but
even such general teaching should be most valu-
able as an adjuvant to the special school training.

Dr. Stewart Paton, of Princeton, recently in-
dicated the general attitude that teachers should
cultivate, based upon observations of persons who
have developed mental peculiarities largely
through lack of this very kind of education. His
attitude toward the subject is given in the follow-
ing passages from one of his recent addresses :

How much meaning there often is in a single
word ! It may decide great issues, epitomize our
hopes or fears or express our entire philosophy
of life. Think what the term " insanity " repre-
sents to the minds of the majority of people ; ap-
prehension, fear, despair — a very gloomy back-
ground. There is one lesson that should be re-
membered, namely, the possibility of discarding
the word insanity and substituting for it the term
maladjustment. We have been told that life is an

2i8 Increasing Your Mental Efficiency

adjustment. As long as the process of this ad-
justment between the individual and environment
persists, life is present, but with its cessation
death intervenes. Disease is an imperfect ad-
justment of which mental disorders are a special
but not specifically different type. By substitut-
ing for insanity the word maladjustment we have
made a great advance.

By this change in our point of view we have
also unconsciously recast some old and difficult
problems in a new form. Think how the whole
educational problem now stands out clearly before
us. Where once we were blindly groping our way
we now follow a plain, straight path.

What is the function of education? What is
the first duty of the teacher? Does it not consist
in an attempt to estimate the adjusting capacity
of every student and then try to help him or her
find a place in life where adjustment is possible?
Think of the figures on the charts showing the
incidence of insanity in the United States. At the
first glance we seem to be looking at a very dark
picture. I do not think, however, that there is
any justification for a gloomy outlook. Eemem-
ber our substitution and then reflect upon the
actual significance of these figures. Do the num-
bers not indicate that there are so many individ-
uals in the community, who have been brought by
defective heredity, undesirable social conditions,
or a poor education into a position where they

Increasing Our National Efficiency 219

cannot readjust? "Why do teachers not realize
that they should assist students to find positions
in life where it is possible for them to work easily,
with pleasure, and at the same time retain their
capacity of readjusting to meet the conditions of
life. We should not dodge the issue. Our present
educational system is to a large extent responsible
for many of the figures recorded on these charts.
If we analyze the statistics carefully there is no
reason to become pessimistic, while there are ex-
cellent grounds for facing the future with hope.

What then is the spirit of the whole movement?
Can we not sum it up in a single word? It seems
to me that such a course is possible. I should
have been very glad to have seen the word teach-
ing dropped from this programme and the word
learning substituted for it. The spirit of the
Mental Hygiene campaign is one of learning, not
of teaching. Dogmatic forms of belief as incul-
cated by many teachers have unfortunately led
directly to many cruel practices. Philippe Pinel
was fortunately a great learner. His spirit of
inquiry led him to afiirm that insanity is a disease
of the body not specifically different from other
physical disorders. Practical results of inesti-
mable value followed close upon his acceptance of
this fundamental principle. Henceforth the in-
sane were to be treated as patients and not as
prisoners nor as those possessed with a devil.
When Pinel stood in the old hospital in Paris and

220 Increasing Your Mental Efficiency

ordered the chains to be removed from these un-
fortunate persons, he opened np a new epoch in
the history of humanity. He did a great deal
more than accomplish a great practical reform, as
he set people thinking along new lines. He form-
ulated many problems, that are of interest to
teachers, in a very striking manner. In his re-
markable book ' ' Nosographie Philosophique ' '
the great number of volumes adorning the shelves
of libraries are contrasted with the meager record
of exact observations conducted upon individuals.
Possibly he had in mind the numbers of physi-
cians and laymen who did not consider insanity
to be a disease simply because writers of books
had entertained an opposite view. May we not
all pause and think about the valuable lesson ex-
pressed in this reflection! He appreciated the
spirit of learning and refers to its importance in
many interesting passages. His observations
taught him that there were not specific differences
between the activities of the sane and the insane.
" In nervous and mental diseases," he declared,
" I see the key which will unlock the secrets of
human nature as they are recorded in history and
moral philosophy. ' '

In order to understand the activities of a
normal person we must often carefully study
those of the abnormal individual. The faculties
of the former are, as a rule, so perfectly balanced
and well adjusted that it is difficult to analyze

Increasing Our National Efficiency 221

them. Disease sometimes comes to our assistance
in the process of analysis and brings out promi-
nently certain symptoms, thus giving a clew to the
interpretation, not only of the activities of the
insane, but which lays bare for us the secrets of
our own nature.

Is it not strange that more than two thousand
years have elapsed since the realization of self-
knowledge; " Know thyself," was represented to
be the highest attainment for which human beings
could strive? Mankind has waited for centuries
before any organized effort was made in this di-
rection. Unfortunately the spirit that Bacon de-
plored is still one of our chief characteristics —
the desire to theorize and to dwell on the top of a
mountain instead of profiting by a descent to the
plain has thwarted our efforts to know ourselves.
For centuries man has reiterated certain false
doctrines in regard to himself, and the din or ar-
gument has served to fix the ideas in conscious-
ness. He has seldom taken the trouble to see
whether these notions tallied with the results of
actual experience. The mental hygiene movement
represents an organized movement to know our-
selves, in order that the knowledge obtained may
be applied to making our lives happier and more
efficient. There are one or two ideas of impor-
tance that should be kept constantly before our
minds in the discussion of this subject. In the
first place we must try and incline people's minds

222 Increasing Your Mental Efficiency

to receive the truth. Fact must be separated from
fiction, and to be capable of distinguishing be-
tween the two it is essential that students should
be trained to associate the study of biology with
the discussion of the human activities. It will be
a very fortunate thing when some university in
this country receives the endowment necessary to
establish a great department of biological psy-
chology entirely independent of the restricted in-
fluences imposed by speculative philosophy.

One of the most fertile ideas of biological
science is that there is an unbroken and uninter-
rupted chain linking the activities of the lowest
with those of the highest organism. If we wish to
understand our own complex activity it is often
necessary to return to the study of the simplest
organisms in order to comprehend the mental
adjustments of the human individual. There is
still another chain that science has shown to be
unbroken, by establishing the fact that there is no
specific qualitative difference between the thought
and conduct of a normal, healthy individual and
that of the patient afflicted with alienation.

A dependent section of the department of bio-
logical psychology should include one of Mental
Hygiene ; where students could go for information
in regard to themselves and for assistance in at-
tempting to estimate their own adjusting capaci-
ties. Practical experience teaches that it would
often be possible to avert many of the disasters

Increasing Our National Efficiency 223

that occur later in life to those who have strug-
gled to attain what in conventionality are called
" the advantages of a higher education." The
surest protection insuring us against the possi-
bility of a mental breakdown is a good heredity
and of almost equal importance the early acquisi-
tion of good mental habits/

1 From an address on " Educational Methods and Mental Effi-
ciency " delivered before the Mental Hygiene Conference in 1912
by Dr. Stewart Paton.

vni

A National Movement to Improve Mental Efficiency

By Thomas W. Salmon, M.D., Director of Special Studies for
the National Committee for Mental Hygiene

ALL efforts to safeguard health are made in
the field of public hygiene (sanitation) or
in that of personal hygiene. In the prevention of
many diseases it is necessary to carry on activi-
ties in both fields.

The measures in public hygiene for the preven-
tion of typhoid fever, for instance, include the
protection of water supplies, the sanitary disposal
of sewage and the destruction of insects which
carry typhoid bacilli from infected material to
food, while in the field of personal hygiene are
the efforts of individuals to raise their immunity
to this disease by inoculation with typhoid vac-
cine and the detection and isolation of ' ' carriers, ' '
those who while well themselves may bear the
disease to others. Again in the prevention of
malaria, destruction of the breeding places of
mosquitoes is a procedure in public hygiene, while
taking prophylactic doses of quinine is a matter
of personal hygiene. There are few diseases

224

A National Movement 225

which can be successfully prevented by efforts
in one of these fields alone.

Until recently, the prevention of mental dis-
eases was thought to be almost wholly a matter of
personal hygiene. It has been shown, however,
that there are public measures in mental hygiene
without which the efforts of individuals are likely
to be unavailing and, on the other hand, much
must be done in the field of personal hygiene, if
the efforts of the community as a whole to lessen
mental disease are to succeed. The preceding
chapters of this book have been devoted very
largely to those principles which must guide the
individual in safeguarding his mental health and
increasing his mental efficiency. The following
short account of the work of a national agency for
mental hygiene may serve to show some means by
which such individual efforts may be initiated
and then coordinated and made effective for the
common welfare.

The National Committee for Mental Hygiene,
founded February 19th, 1909, came into existence
because of the conviction among some of those
whose work had brought them closely into contact
with the problem of mental diseases that there
was urgent need for a national agency to help
raise standards in the care and treatment of the
insane and to work for the prevention of mental
and nervous disorders.

The way in which this sentiment was crystal-

225 Increasing Your Mental Efficiency

lized has been described as follows by Dr.
LeweUys F. Barker, in an address delivered at the
Fifteenth International Congress on Hygiene and
Demography: " This impulse, thanks to the
initiative of a layman, Clifford W. Beers, author
of ' A Mind That Found Itself ' (now Secretary
of the National Committee), whose personal suf-
ferings led him, on recovery, to devote himself to
the cause of mental hygiene, and who enlisted the
cooperation of a group of representative men and
social workers, has found expression in the vol-
untary formation of a National Committee for
Mental Hygiene."

While new methods of treatment and hopeful
measures for prevention have been eagerly wel-
comed and very effectively applied in other fields
of medicine, this has not been the case in the care
of the insane and the prevention of mental dis-
eases. In this country at the present time the
care of those ill with mental diseases varies in
the different States from the kind of treatment
which humanity requires for all other classes of
the sick to methods which have come down to us
from an age when the insane were looked upon
with superstitious fear and when cruelty and
neglect were their usual portion. It is apparent
that only a nation-wide movement — carefully
planned, scientifically directed and adequately
financed — can deal with the varied and complex
causes for these conditions or, indeed, even can

A National Movement 227

secure the accurate information necessary for ef-
fective work in ameliorating them.

The Importance of the Problem

On the date of the last federal census, January
1, 1910, there were 187,454 persons in institutions
for the insane in this country. This number ex-
ceeds the number of students in all the colleges
and universities in the United States. It exceeds
the number of officers and enlisted men in the
United States Army, Navy, and Marine Corps,
and it exceeds the population of Columbus, Ohio,
the twenty-ninth city in size in this country.
About 30,000 new cases of mental disease are ad-
mitted to institutions in the United States each
year and the annual increase in the number of
patients under treatment is about 6,000. If all the
States provided for their insane as adequately as
do New York and Massachusetts, there would be
more than 300,000 patients in institutions. A
more concrete illustration of the prevalence of in-
sanity is the fact that the number of hospital beds
for the insane in New York City exceeds the
number of hospital beds in all the general hos-
pitals of that city.

The cost of caring for the insane in a State
making adequate provisions exceeds any other
single item of expense, except the amount ex-
pended for public education. The average annual

228 Increasing Your Mental Efficiency

cost of maintenance in institutions for the insane
in the United States is about $175 per patient,
making the total cost during the year 1910 for
those in institutions, $32,804,450. As it is esti-
mated that the cost of the Panama Canal will be
$325,201,000, and that it has taken almost ten
years for its completion, it is seen that the annual
cost of caring for the insane is greater than the
annual cost of construction of that great work.
The latter sum is so great that it was deemed
necessary to distribute it over a number of years
by the issuance of bonds ; whereas the cost of car-
ing for the insane is an annual expense, which
has to be met from current revenues of the
States.

In order to state fairly the cost of mental dis-
eases there must be added to this great sum the
economic loss to the country through the with-
drawal from productive labor of so many people
in the prime of life. It has been stated by the
United States Commissioner of Labor that the
average value to the community of an adult be-
tween the ages of 18 and 45 is $700 a year. Esti-
mated upon this basis, the annual economic loss to
the United States through the confinement of
187,454 people in institutions for the insane is
more than $130,000,000. If this is added to the
cost of maintenance the total is more than
$162,000,000 — an amount equal to the entire value
of the wheat, corn, tobacco, dairy products, and

A National Movement 229

beef products exported annually from the United
States.

Such statistics serve as a means of comparison
but they cannot convey an adequate idea of the
most serious results of mental diseases — the per-
sonal suffering and unhappiness, the social and
family disasters and the business troubles which
they cause. It should be remembered that the
same factors which bring about the commitment of
people to institutions for the insane are responsi-
ble for much inental disease which is never recog-
nized and for loss of efficiency, failure to meet
difficult situations of life and conflicts with
conventions and laws. These often depend upon
mental disorders or mental defects, although the
fact is not generally recognized. Accounts of
murders, suicides, marriage troubles and many
kinds of misdemeanors often have a very definite
meaning for those who are familiar with the ab-
normalities of conduct which result from mental
disease. The frequency of these social disasters
indicates the inadequacy of present methods of
dealing with the problem of mental diseases.

Humanitarian and economic reasons alike call
for organized efforts to control the spread of in-
sanity. It is known that there are certain essential
causes of mental disease and that some of these
essential causes are within our control. In 1913,
499 persons died from typhoid fever in New York
City, while more than 500 persons with general

230 Increasing Your Mental Efficiency

paresis (all of them certain to die of their dis-
ease) were admitted during the same period and
from the same population to hospitals for the in-
sane. Syphilis causes other mental diseases, and
there is probably no other single cause for insan-
ity responsible for a greater number of cases. In
spite of this it is an amazing fact that many of
those most active in the field of venereal prophy-
laxis are not aware that such a prevalent and uni-
formly fatal disease as general paresis depends
upon previous infection with syphilis. About 20
per cent, of all first admissions to hospitals
for the insane are on account of the alcoholic
psychoses, forms of mental disease which depend
upon another essential cause of insanity. These
are two controllable causes of mental disease.

In the varied conditions capable of producing
mental disease there are many other controllable
causes, some of them deeply imbedded in the
social fabric and touching many phases of per-
sonal life, education, and general preventive
medicine. This fruitful and most important field
for work in the prevention of disease has prac-
tically been neglected thus far, very largely on
account of lack of popular information.

The most effective work in the prevention of
insanity, as well as in increasing the efficiency and
happiness of those who do not become insane,
must be done in early life. We know that much
mental disease and more disaster from imperfect

A National Movement 231

adjustments to life of a little different sort depend
upon inadequate equipment to deal with difficult
situations and upon attempts of people to live
upon levels of activity for which their mental
equipment and training have not fitted them. We
know that in not a few cases these inadequacies
of equipment and this tendency on the part of
people to take up tasks for which they are mani-
festly unfitted may be recognized at a very early
period and we suspect that much could be done
by recasting educational methods and providing
for individual needs to remedy these conditions.
This, after all, is the true purpose of mental
hygiene. As issues become clearer and people
turn to the consideration of these subjects it will
fall to this Committee to give constructive sugges-
tions for including in the purposes of education
the determination of the levels of capacity of dif-
ferent individuals at which life may be conducted
the most successfully. We may be able to show
that any educational system should include the
recognition and possible correction in the schools
of tendencies which may wreck happiness and
usefulness in future years.

General Plan of the Work

What has been presented is a very broad outline
of the field which the National Committee for
Mental Hygiene has entered. It is realized fully

232 Increasing Your Mental Efficiency

that in such an immense field efforts might easily
be so poorly directed as to accomplish few specific
results. With this in mind, a plan for systematic,
constructive work, by which different phases of
the subject are to be dealt with one at a time, has
been prepared. Nearly three years were devoted
to careful study before this plan was adopted
and it was decided that the time had come to com-
mence active work and to appeal for support.
The plan may be summarized under three prin-
cipal heads. The first is original inquiry regard-
ing the status of the care of the insane in this
country — including not only care of patients in
special institutions but care in the communities,
in general hospitals, and pending admission to
hospitals; regarding the opportunities for effec-
tive work in betterment, and prevention and, as
resources permit, regarding some of the more
important controllable causes of mental disease.
The second is popular education, by which the im-
portance of the subject can be impressed upon the
public, and facts already known and those ascer-
tained by special studies regarding conditions for
care and treatment, and the preventable causes of
mental diseases, can be made widely known. The
third is the orgamization of agencies to take part
in movements for betterment and prevention, in-
cluding existing agencies (Federal, State, and
local) and State and local societies for mental
hygiene organized for these special purposes.

A National Movement 233

The following outline of the work proposed
under the heading original inquiry is from the
plan of work adopted:

" A study will be made of the operation of the
laws relating to insanity and the insane ; the offi-
cial methods of dealing with mental cases ; the ex-
tent and character of institutional care; the
extent and character of care outside of special in-
stitutions, the methods of discharge of patients
and their return to normal conditions, and such
other particulars as it may seem necessary to in-
quire into with a view of securing for the National
Committee full and accurate information concern-
ing the situation in the several States."

Work in accordance with these plans has been
carried on steadily during the past two years. It
seemed essential at the outset to obtain a clear
idea of the provisions for the care and commit-
ment of the insane in the several States which are
afforded by present statutes. The kind of care
received by the insane depends upon legislation
more than does the care of any other classes of
the sick. Indeed, good laws regarding the insane
are the essential foundation for good care, so we
secured the services of Mr. John Koren, who for
several years had been in charge of the statistical
studies of the insane made by the United States
Census Bureau, and who had already collected a
great deal of material on this subject. Mr. Koren
prepared a summary of these laws, which has

234 Increasing Your Mental Efficiency

been published by this Committee, and which has
proved of great use not only to us but to others
interested.

Besides information regarding special topics, a
great deal of general statistical information relat-
ing to some of the larger aspects of our problem
(such as the prevalence of mental disease, its re-
lation to immigration, etc.) has been gathered
and made freely available to all who desire it.

In view of the vital importance of improving
facilities for early diagnosis and treatment of
mental diseases, special efforts have been made to
obtain all the information available regarding
psychiatric clinics and psychiatric wards, and pa-
vilions in connection with general hospitals.
Plans of nearly all such institutions in the United
States have been secured and redrawn to a uni-
form scale. A publication will be issued describ-
ing them and giving detailed information as to
their cost and cost of maintenance, the organiza-
tion of their medical and administrative services,
the purposes intended to be served and the actual
results obtained. It has been found possible to
have excellent prints in black and white made of
these plans. A number have been secured so that
persons seeking information on this subject can
be supplied.

Studies of a number of such special problems as
the unique mode of care known as the " Wiscon-
sin system " have been carried on.

A National Movement 235

It has been encouraging and especially interest-
ing to have many spontaneous appeals made to
us for information on various phases of mental
hygiene. The following requests for information,
which were received during a very short period,
may serve as illustrations :

The medical examiner of a State Bureau of
Child Labor asked for detailed suggestions for
making mental examinations of children applying
for labor permits.

A vigilance association asked for information
regarding the relation between syphilis and in-
sanity and, after receiving it, printed a special
pamphlet on the subject.

The Master-in-Lunacy of the State of Victoria,
Australia, asked for information regarding the
early treatment of mental diseases in psycho-
pathic hospitals and psychopathic wards in gen-
eral hospitals.

The Tuberculosis Committee asked for infor-
mation regarding the relation between tubercu-
losis and mental disease.

The Director of Physical Training in the public
schools of a large city asked for an outline on
mental hygiene to include in a course on hygiene
for teachers.

The Secretary of the Young Men's Christian
Association in Peking, China, asked for publica-
tions on mental hygiene to be placed in a library
used by oflQcials and students.

A clergyman engaged in a " no-license" cam-
paign in the West asked for charts showing the

236 Increasing Your Mental Efficiency

relation between alcohol and insanity for display
in store windows.

The Director of the Bureau of Social Welfare
in a western university asked for suggestions for
useful fields of effort for an extension division.

A number of teachers of biology and of sociol-
ogy in universities asked for data on various
phases of mental hygiene to use in their classes.

The editor of a magazine in the South asked for
information regarding the relation of immigration
to insanity.

An instructor in sociology in a southern college
asked for suggestions for a genetic survey of a
town of 1,200 inhabitants.

The Director of a hospital for the insane in
Canton, China, asked for data on the causes of
insanity to translate into Chinese for wide distri-
bution.

A member of a lodge of young men in the West
asked for a frank statement regarding the
physiological effects of contiaence, stating that
he had been delegated to do so by the others who
were sincere in asking for information for their
own guidance.

A Professor in Wellington College, Cape Col-
ony, South Africa, asked for information regard-
ing mental hygiene and the formation of a mental
hygiene exhibit.

The Attending Physician of a rescue home for
girls asked for advice regarding psychological
andjpsychiatrical studies of girls in her care.

A number of persons submitted proposed
amendments to insanity laws in different States
and asked for opinions as to their form and pur-
poses.

A National Movement 237

The Bureau of Criminology Eesearch in the
Department of Sociology of a large university
asked for advice regarding certain researches
into the relation between mental defect and crime
which the Bureau was about to undertake.

These are typical inquiries. An attempt is
made to give a very careful answer in each case.
This necessitates, of course, a considerable
amount of inquiry and consultation with those
most familiar with the different problems. It con-
sumes a great deal of time, but it seems very de-
sirable to meet such demands adequately, for one
of the objects mentioned in the statement of our
plans is " to serve as a clearing house for the na-
tion on the subject of nervous and mental disor-
ders, and in the care and treatment of the in-

Social Service by Correspondence

While it is not one of the purposes of the Na-
tional Committee for Mental Hygiene to give aid
in individual cases, that being a function of local
agencies, many such cases have been presented in
a way making it impossible to withhold advice or
assistance. Several articles relating to the work
of this committee appearing at about the same
time in the " Outlook," the " Cosmopolitan," and
the " American " magazines, gave rise to a flood
of letters from nearly all the States, and from

238 Increasing Your Mental Efficiency

several foreign countries. Some of these letters
could be answered by the statement that the ad-
vice desired could not be given without a personal
examination, or that publications on the special
topic mentioned were not, at the time, available,
but more than five hundred of these inquiries have
received careful personal attention, so urgent
seemed the need for advice. Quite a number of
persons suffering from mental diseases have, by
this means, been placed in touch with physicians
in different localities. In order that this may be
done most effectively, a card-index has been pre-
pared of the physicians in the different States
who are members of psychiatrical or neurological
societies or who are known to have devoted
especial attention to mental diseases.

Thus it will be seen that this purely philan-
thropic organization has become a national insti-
tution for increasing mental efficiency. It is a
unique organization, and is proving a most helpful
one. For it dispenses information about topics
of utmost importance to the individual — ^informa-
tion that it is practically impossible for most
persons to acquire in any other way at the present
time. In effect it is a national free clinic con-
ducted by competent persons whose object is to
better the condition of the individual directly,
and thus indirectly raise the general standard of
mental efficiency.

A National Movement 239

One cannot help being impressed by the help-
lessness in dealing with mental illness which these
appeals disclose. They provide material for a
very convincing statement of the need for local
societies or committees for mental hygiene to deal
with personal problems.

Aid in Movements for Betterment

Efforts have been made to assist in every
movement to improve conditions among the in-
sane or to undertaken in prevention which has
come to our attention. We have furnished infor-
mation or advice, or have cooperated in other
ways, in attempts to secure better laws or to deal
with special problems in Alaska, California, Con-
necticut, Maine, Massachusetts, Minnesota, Mis-
souri, New Jersey, New York, Oklahoma,
Pennsylvania, Texas, and Wisconsin.

One of the stated objects of this Committee is :
" To enlist the aid of the Federal Government so
far as may seem desirable." The most important
step taken by this Committee toward this end
was an interview with President Wilson. The
importance of the subject of mental hygiene was
presented, and each of the points of contact which
the Federal Government has with mental hygiene
was mentioned. Some of these are the work of
the Public Health Service in general preventive

240 Increasing Your Mental Efficiency

medicine, but particularly in the mental examina-
tion of immigrants, and in the dissemination of
information regarding the causes and prevention
of disease; that of the Census Bureau regarding
the insane in institutions; that of the Bureau of
Education; the care of the insane in Alaska and
in our insular possessions ; the care of insane In-
dians; the work of the Government Hospital of
the Insane, and the work of the recruiting services
of the Army and Navy. In this connection it is
not without interest that a very defective commit-
ment law and most inadequate quarters for the
detention of alleged insane persons pending their
commitment are to be found in the District of
Columbia.

This Committee has directed attention to the
importance of the exclusion of the insane and
mentally defective immigrants. Assistance and
advice has been given to several official Commis-
sions appointed to study this subject. Eepresent-
atives of the Committee have appeared before
Committees in Congress and they were present
at a hearing given by President Taft in 1913. In
all that has been done, especial pains have been
taken to make it clear that our interest in immi-
gration problems relates only to this particular
phase. Better and more humane methods of de-
portation have also received attention, and some
suggestions made by us have already been put
into effect.

A National Movement 241

State Societies and Committees for Mental Hygiene

During the past year the growth of the work of
State Societies and Committees for Mental
Hygiene and the development of interest in such
agencies in States where they have not yet been
organized has been steady and gratifying.

State Societies are now in operation in Con-
necticut, Illinois, Massachusetts, and North Caro-
lina, and their equivalents, in the form of Mental
Hygiene Committees which are sub-committees
of some other organization, are in operation in
New York, Maryland, and Pennsylvania. These
seven agencies are affiliated with the National
Committee and look to it for advice and assist-
ance, thus making it possible for our National
agency to help standardize and coordinate th6
work. In Rhode Island, Maine, Indiana, Michi-
gan, California, and Texas, moves toward organ-
izing societies are also being made.

In this brief report, a description of the work
of the several State Societies and Committees
cannot be given. Suffice it to say, that such
agencies are now at work in States which on Jan-
uary 1, 1910, had 80,119 patients in hospitals for
the insane — nearly one-half of the total number of
patients in such institutions in this country.
"When the agencies now in process of organization
shall have begun work. State Societies for Mental
Hygiene will be working for improved care and

242 Increasing Your Mental Efficiency

treatment for more than 110,000 of the 187,454
insane patients reported in institutions in the
United States on January 1, 1910.

Interest in Other Countries

In Canada, the Canadian Medical Society has
organized a Mental Hygiene Committee which
"will be represented at the Convention in Balti-
more. In South Africa, also, a Society, known as
the " South African Committee on Mental
Hygiene," was founded last June. Thus the
movement may be said to be already international
in scope.

It is the aim of the National Committee for
Mental Hygiene to bring about a new realization
of how the insane have failed to share in the ad-
vance in the care of the sick and cause, also, a
general awakening to the fact that the prevention
of mental diseases has thus far failed to become a
part of the advance in preventive medicine.
When these neglected responsibilities are as-
sumed, the returns will be as large as those re-
sulting from any other work for human
happiness and efficiency which is being under-
taken to-day.